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Thursday, March 23, 2006

Periodontitis Is Linked to Coronary Heart Disease

Periodontal infection, and the pathogen burden in particular, is associated
with the presence of coronary heart disease (CHD), according to findings
published in the March 13th issue of the Archives of Internal Medicine.
"Chronic inflammation from any source is associated with increased
cardiovascular risk," Dr. Wolfgang Koenig, of the University of Ulm Medical
Center, Germany, and colleagues write. "Periodontitis is a possible trigger
of chronic inflammation."
In examining the association between CHD and periodontitis, the researchers
focused on microbial features of the disorder. A total of 789 subjects (263
with stable CHD and 526 matched controls with no history of CHD) were
enrolled in the Coronary Event and Periodontal Disease study.
DNA-DNA hybridization was used to analyze subgingival biofilm samples for
periodontal pathogens Actinobacillus actinomycetemcomitans, Tannerella
forsythensis, Porphyromonas gingivalis, Prevotella intermedia, and Treponema
Results of multivariable analyses demonstrated a significant association
between total periodontal pathogen burden (log10 of the sum of all
pathogens) and the presence of CHD (odds ratio 1.92, p < 0.001).
A significant association was also found between the number of A.
actinomycetemcomitans in periodontal pockets (log10) and CHD (OR 2.70, p <
"Periodontal pathogens may increase the risk of CHD through various
mechanisms (e.g., by platelet activation and aggregation)," Dr. Koenig's
team explains.
"Experimental studies suggest the potential of periodontal pathogens or
their respective products, such as lipopolysaccharide, to activate
mononuclear phagocytes," they note. "Furthermore, it has been demonstrated
that macrophages can accumulate cholesterol-rich lipids such as oxidized
low-density lipoprotein and convert to large foam cells on interaction with
periodontal pathogens."
A potentially prominent role for A. actinomycetemcomitans is supported by a
recent finding that high serum anti-actinomycetemcomitans antibody levels
predict stroke.


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