Summary

Background

Periodontal disease and cardiovascular disease are often linked, but it was unclear whether the link is independent of shared risk factors, and through which mechanism. This study tested whether active inflammation of the periodontium predicts future cardiovascular events, and whether arterial inflammation explains the connection.

Materials and methods

Inflammation of the periodontium and of the arteries was measured on 18F-FDG PET/CT scans of 304 adults (median age 54; 42% men), imaged mostly for cancer screening and without active cancer. Participants were then followed for major adverse cardiovascular events (MACE).

Results

Over a median follow-up of 4.1 years, 13 participants had a major cardiovascular event. Periodontal inflammation was associated with arterial inflammation, even after adjusting for periodontal and cardiovascular risk factors. It also predicted future events (standardized hazard ratio 2.25), while periodontal bone loss did not. Arterial inflammation accounted for about 80% of the link between periodontal inflammation and cardiovascular events.

Conclusion

Active inflammation of the periodontium, rather than bone loss alone, is independently associated with future cardiovascular events, possibly through increased inflammation of the arteries.

Keywords

periodontal inflammation, cardiovascular disease, atherosclerosis, FDG-PET/CT, oral-systemic health

Source: J Periodontol, 2021 (PubMed)