Periodontitis is associated to increased systemic inflammation in postmyocardial infarction patients

Open Heart. 2021 Aug;8(2):e001674. doi: 10.1136/openhrt-2021-001674.

Abstract

Objective: Periodontitis has been independently associated to cardiovascular disease. However, the biological mechanisms underlying such association are still partially unknown. Thus, this study aimed to discover immunological clues accounting for the increased risk of myocardial infarction (MI) in patients having periodontitis.

Methods: We included 100 patients with a first MI, 50 with and 50 without severe periodontitis, and 100 age-matched, sex-matched and area-matched controls from the Periodontitis and Its Relation to Coronary Artery Disease Study. Participants underwent comprehensive clinical and laboratory examinations 6-10 weeks after the MI and plasma expression of 92 inflammation-related markers was assessed through proximity extension assay.

Results: Patients who had an MI displayed altered expression of CCL19, TNFRSF9 and LAP TGF-β1 in comparison with controls. TNFRSF9 correlated significantly with the amount of alveolar bone loss. MI patients with deep periodontal pockets showed increased white cell count and higher expression of FGF-21, HGF, OSM, CCL20 and IL-18R1 than patients without. White cell count correlated significantly with four of these proteins.

Conclusions: Collectively, our results indicate molecular markers that could be responsible for the increased systemic inflammatory activity in patients with MI with periodontitis.

Keywords: biomarkers; inflammation; myocardial infarction.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • Chemokine CCL20 / biosynthesis
  • Chemokine CCL20 / blood*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fibroblast Growth Factors / biosynthesis
  • Fibroblast Growth Factors / blood*
  • Follow-Up Studies
  • Humans
  • Interleukin-18 Receptor alpha Subunit / biosynthesis
  • Interleukin-18 Receptor alpha Subunit / blood*
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / complications*
  • Oncostatin M / biosynthesis
  • Oncostatin M / blood*
  • Periodontitis / blood
  • Periodontitis / complications*
  • Retrospective Studies
  • Risk Factors
  • Systemic Inflammatory Response Syndrome / blood
  • Systemic Inflammatory Response Syndrome / etiology*
  • Time Factors

Substances

  • Biomarkers
  • CCL20 protein, human
  • Chemokine CCL20
  • IL18R1 protein, human
  • Interleukin-18 Receptor alpha Subunit
  • OSM protein, human
  • fibroblast growth factor 21
  • Oncostatin M
  • Fibroblast Growth Factors