Abstract 20033: Periodontal Disease Activity Independently Predicts Future Risk for Cardiovascular Events
Background: While several lines of evidence show a link between periodontal disease (PD) and cardiovascular disease (CVD), the independence of this association is still debated and the mechanisms mediating the association have not been clearly demonstrated.
Objectives: We tested the hypotheses that: 1) periodontal inflammation, measured as PD activity (PDA) is an independent risk factor for CVD and that 2) the association between the two is mediated by arterial inflammation.
Methods: 305 patients without prior CVD underwent (18)F-FDG-PET/CT imaging for clinical indications and were deemed to be free of oncologic or inflammatory diseases at imaging. Periodontal FDG uptake was measured by obtaining standardized uptake values from the periodontal tissue, and the ratio of periodontal to background (blood) activity was recorded as the target to background ratio (TBR). Standardized uptake value measurements were obtained in the aorta as well as in spell out (SVC) and the arterial TBR ratio was calculated to provide an index of arterial inflammation. Image analyses and CVD event adjudication were performed by blinded investigators. Relationships between PDA and cardiovascular events were evaluated using Cox models and Kaplan-Meier log-rank tests. Path analysis was used to assess the role of arterial inflammation for mediating the effect of PDA on CVD.
Results: The mean age of participants was 54 years; 130 (42.6%) were male. During follow-up (median 4.2 years) 13 participants developed a cardiovascular event. PDA associated with aortic inflammation (r=0.59, P<0.001). PDA predicted subsequent CVD events in univariate (HR=1.59, P<0.01) and in multivariate models after adjusting for Framingham Score (P<0.05) and risk factors for periodontitis (P<0.01). Furthermore, path analysis indicated that 80% of the relationship between PDA and CVD was mediated by increased arterial inflammation (P=0.022).
Conclusions: These findings demonstrate that PDA is an independent risk factor for atherosclerotic diseases and provide important insights into the inflammatory mechanism mediating the association.
Author Disclosures: A. Ishai: None. R. Takx: None. A. Abdelrahman: None. K. ElKholy: None. T. Van Dyke: None. A. Tawakol: None.
- © 2016 by American Heart Association, Inc.