Periodontitis linked to poorer cardiovascular outcome

Summarised from:

Does Periodontitis Increase the Risk for Future Cardiovascular Events? Long-Term Follow-Up of the PAROKRANK Study
(Journal of Clinical Periodontology; doi: 10.1111/jcpe.14064)

Authors:

Anna Norhammar, Per Näsman, Kåre Buhlin, Ulf de Faire, Giulia Ferrannini, Anders Gustafsson, Barbro Kjellström, Thomas Kvist, Eva Levring Jäghagen, Bertil Lindahl, Åke Nygren, Ulf Näslund, Elisabet Svenungsson, Björn Klinge, Lars Rydén, PAROKRANK Study Group

Summarised by:

Dr Varkha Rattu

Research Topic:

Background + Aims

Periodontitis and cardiovascular disease share risk factors and inflammatory pathways. However, an association does not establish whether periodontal inflammation directly contributes to cardiovascular disease or reflects other underlying risks.
This study aimed to:
- Examine whether baseline periodontitis predicted subsequent cardiovascular events and mortality

Materials + Methods

Prospective PAROKRANK follow-up of 1,587 Swedish participants, including myocardial infarction survivors and matched controls.
Periodontal classification used radiographic bone loss.
Mean follow-up was 9.9 years, with outcomes identified through national registries.
The composite endpoint included all-cause death, non-fatal myocardial infarction, stroke or heart-failure hospitalisation.
Cox regression assessed the association after adjustment for age, smoking and diabetes

Results

Events occurred in 174/602 participants with periodontitis (29%), compared with 187/985 without periodontitis (19%).
The adjusted hazard ratio was 1.26 (95% CI 1.01–1.57; p=0.038).
- This indicates a 26% higher hazard during follow-up, rather than a 26% increase in absolute risk.
As the endpoint combined several outcomes, the overall association does not establish an equivalent increase in each individual outcome.

Limitations

Observational design and residual confounding limit causal inference.
Radiographic bone loss reflects historical damage rather than current inflammation.
Changes in periodontal status and treatment were unavailable.
The selected cohort limits generalisability

Conclusion

Periodontitis may identify individuals with poorer cardiovascular prognosis. These findings support further investigation, but do not demonstrate that periodontal treatment prevents cardiovascular events.

Read the full article Back to Research

Research | 11.09.24

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