Khandelwal A, Anegundi R-V, Yadalam P-K, Shenoy S-B, Subramanyam K, Ardila C-M
Department of Periodontics NITTE (Deemed to be University) AB Shetty Memorial Institute of Dental Sciences Derlakatte, Mangalore, Karnataka, India
Med Oral Patol Oral Cir Bucal. 2025 Mar 1;30(2):e306-e312. doi: 10.4317/medoral.26946.
Growing evidence suggests a potential link between periodontal disease and the development of atherosclerosis, positioning periodontal disease as a possible risk factor for cardiovascular diseases (CVD). This study aimed to evaluate periodontal status in patients with coronary artery disease (CAD) by measuring the Periodontal Inflamed Surface Area (PISA) score in individuals undergoing coronary angiography.
In this cross-sectional study, 300 patients scheduled for coronary angiography at K.S. Hegde Medical Hospital, Mangalore, India, were recruited. Comprehensive medical and dental histories were obtained prior to the procedure. The PISA score was calculated using standardized periodontal measurements. Patients were categorized into three groups based on angiographic findings: no coronary artery blockage, blockage in one or more vessels with <50% stenosis, and blockage in one or more vessels with ≥50% stenosis. Additional subgroup analyses were conducted for single-, double-, and triple-vessel disease. A p-value of <0.05 was considered statistically significant.
A significant increase in PISA scores was observed in patients with ≥50% coronary artery stenosis compared to those with <50% stenosis and no stenosis. However, the extent of vessel obstruction appeared independent of the degree of periodontal destruction.
This study suggests that periodontal disease may act as a pro-atherogenic factor in the context of CAD, potentially contributing to the progression of atherosclerosis rather than being a direct causative agent. These findings underscore the importance of considering oral health in cardiovascular risk assessment and management for patients with coronary artery disease.
越来越多的证据表明牙周病与动脉粥样硬化的发展之间存在潜在联系,这使牙周病成为心血管疾病(CVD)的一个可能危险因素。本研究旨在通过测量接受冠状动脉造影的个体的牙周炎症表面积(PISA)评分,评估冠心病(CAD)患者的牙周状况。
在这项横断面研究中,招募了印度芒格洛尔K.S.赫格德医学院医院计划接受冠状动脉造影的300名患者。在手术前获取了全面的医学和牙科病史。使用标准化的牙周测量方法计算PISA评分。根据血管造影结果将患者分为三组:无冠状动脉阻塞、一支或多支血管阻塞且狭窄程度<50%、一支或多支血管阻塞且狭窄程度≥50%。对单支、双支和三支血管疾病进行了额外的亚组分析。p值<0.05被认为具有统计学意义。
与狭窄程度<50%和无狭窄的患者相比,冠状动脉狭窄程度≥50%的患者PISA评分显著增加。然而,血管阻塞的程度似乎与牙周破坏的程度无关。
本研究表明,在冠心病的背景下,牙周病可能作为一种促动脉粥样硬化因子,可能促进动脉粥样硬化的进展,而不是直接的致病因素。这些发现强调了在冠心病患者的心血管风险评估和管理中考虑口腔健康的重要性。