Inflammation of the periodontium associates with risk of future cardiovascular events.

Abstract

BACKGROUND\nWhile growing evidence suggests a link between periodontal\xa0disease (PD) and cardiovascular disease (CVD), the independence of this association and the pathway remain unclear. Herein, we tested the hypotheses that: 1) inflammation of the periodontium (PDinflammation ) predicts future CVD independently of disease risk factors shared between CVD and PD, and 2) the mechanism linking the two diseases involves heightened arterial inflammation.\n\n\nMETHODS\n18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG-PET/CT) imaging was performed in 304 individuals (median age 54 years; 42.4% male) largely for cancer screening; individuals without active cancer were included. PDinflammation and arterial inflammation were quantified using validated 18 F-FDG-PET/CT methods. Additionally, we evaluated the relationship between PDinflammation and subsequent Major Adverse Cardiovascular Events (MACE) using Cox models and log-rank tests.\n\n\nRESULTS\nThirteen individuals developed MACE during follow-up (median 4.1 years). PDinflammation associated with arterial inflammation, remaining significant after adjusting for PD and CVD risk factors (standardized β [95% CI]: 0.30 [0.20-0.40], p<0.001). PDinflammation predicted subsequent MACE (standardized HR [95% CI]: 2.25 [1.47-3.44], p<0.001, remaining significant in multivariable models), while periodontal bone loss did not. Furthermore, mediation analysis suggested that arterial inflammation accounts for 80% of the relationship between PDinflammation and MACE (standardized log odds ratio [95% CI]: 0.438 [0.019-0.880], p = 0.022).\n\n\nCONCLUSION\nPDinflammation is independently associated with MACE via a mechanism that may involve increased arterial inflammation. These findings provide important support for an independent relationship between PDinflammation and CVD. This article is protected by copyright. All rights reserved.