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The Association Between Periodontitis and Cardiovascular Disease: an Update

  • Coronary Heart Disease (S. Virani and S. Naderi, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

The purpose of this review is to provide an update on the data regarding periodontitis and its association with cardiovascular disease (CVD), as well as a closer look at the connection between periodontitis and valvular heart disease.

Recent Findings

The body of literature that demonstrates an association between periodontitis and CVD is growing, and there is increasing evidence that periodontal disease (PD) can have negative cardiovascular effects. Far less data is available for the management of periodontitis specifically in those with valvular heart disease. However, recent studies suggest that routine preoperative dental evaluation practices may not be necessary in all patients and, similar to changes in antibiotic prophylaxis, may only be indicated for a select group of individuals.

Summary

There is a strong association between PD and CVD, although a causal relationship is yet to be elucidated. Further data is needed in this regard, as well as in determining the appropriate management of PD in those with valvular heart disease.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Friedewald VE, Kornman KS, Beck JD, Genco R, Goldfine A, Libby P, et al. The American Journal of Cardiology and Journal of Periodontology Editors’ Consensus: periodontitis and atherosclerotic cardiovascular disease. Am J Cardiol. 2009;104:59–68.

    Article  Google Scholar 

  2. Stewart R, West M. Increasing evidence for an association between periodontitis and cardiovascular disease. Circulation. 2016;133:549–51.

    Article  Google Scholar 

  3. Willerson JT, Ridker PM. Inflammation as a cardiovascular risk factor. Circulation. 2004;109:II2–10.

    PubMed  Google Scholar 

  4. Cahill TJ, Baddour LM, Habib G, Hoen B, Salaun E, Pettersson GB, et al. Challenges in infective endocarditis. J Am Coll Cardiol. 2017;69:325–44.

    Article  Google Scholar 

  5. Merchant AT, Virani SS. Evaluating periodontal treatment to prevent cardiovascular disease: challenges and possible solutions. Curr Atheroscler Rep. 2017;19:4.

    Article  Google Scholar 

  6. Aday AW, Ridker PM. Antiinflammatory therapy in clinical care: the CANTOS trial and beyond. Front Cardiovasc Med. 2018;5:62.

    Article  Google Scholar 

  7. Mustapha IZ, Debrey S, Oladubu M, Ugarte R. Markers of systemic bacterial exposure in periodontal disease and cardiovascular disease risk: a systematic review and meta-analysis. J Periodontol. 2007;78:2289–302.

    Article  Google Scholar 

  8. Haraszthy VI, Zambon JJ, Trevisan M, Zeid M, Genco RJ. Identification of periodontal pathogens in atheromatous plaques. J Periodontol. 2000;71:1554–60.

    Article  CAS  Google Scholar 

  9. Reyes L, Herrera D, Kozarov E, Rolda S, Progulske-Fox A. Periodontal bacterial invasion and infection: contribution to atherosclerotic pathology. J Periodontol. 2013;84:S30–50.

    Article  Google Scholar 

  10. Vedin O, Hagstrom E, Gallup D, Neely ML, Stewart R, Koenig W, et al. Periodontal disease in patients with chronic coronary heart disease: prevalence and association with cardiovascular risk factors. Eur J Prev Cardiol. 2015;22:771–8.

    Article  Google Scholar 

  11. Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol. 2008;35:277–90.

    Article  CAS  Google Scholar 

  12. Tonetti MS, D'Aiuto F, Nibali L, Donald A, Storry C, Parkar M, et al. Treatment of periodontitis and endothelial function. N Engl J Med. 2007;356:911–20.

    Article  CAS  Google Scholar 

  13. Desvarieux M, Demmer RT, Rundek T, Boden-Albala B, Jacobs DR Jr, Papapanou PN, et al. Oral I and vascular disease epidemiology S. relationship between periodontal disease, tooth loss, and carotid artery plaque: the oral infections and vascular disease epidemiology study (INVEST). Stroke. 2003;34:2120–5.

    Article  Google Scholar 

  14. Ryden L, Buhlin K, Ekstrand E, de Faire U, Gustafsson A, Holmer J, et al. Periodontitis increases the risk of a first myocardial infarction: a report from the PAROKRANK study. Circulation. 2016;133:576–83.

    CAS  PubMed  Google Scholar 

  15. • Czesnikiewicz-Guzik M, Osmenda G, Siedlinski M, Nosalski R, Pelka P, Nowakowski D, et al. Causal association between periodontitis and hypertension: evidence from Mendelian randomization and a randomized controlled trial of non-surgical periodontal therapy. Eur Heart J. 2019;40:3459–70. This paper outlines evidence for blood pressure lowering effects of periodontitis treatment.

    Article  Google Scholar 

  16. Brown TT, Dela Cruz E, Brown SS. The effect of dental care on cardiovascular disease outcomes: an application of instrumental variables in the presence of heterogeneity and self-selection. Health Econ. 2011;20:1241–56.

    Article  Google Scholar 

  17. Offenbacher S, Beck JD, Moss K, Mendoza L, Paquette DW, Barrow DA, et al. Results from the periodontitis and vascular events (PAVE) study: a pilot multicentered, randomized, controlled trial to study effects of periodontal therapy in a secondary prevention model of cardiovascular disease. J Periodontol. 2009;80:190–201.

    Article  Google Scholar 

  18. Liesenborghs L, Meyers S, Vanassche T, Verhamme P. Coagulation: At the heart of infective endocarditis. J Thromb Haemost. 2020;18:995–1008.

    Article  Google Scholar 

  19. Murdoch DR, Corey GR, Hoen B, Miro JM, Fowler VG Jr, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med. 2009;169:463–73.

    Article  Google Scholar 

  20. Di Filippo S, Delahaye F, Semiond B, Celard M, Henaine R, Ninet J, et al. Current patterns of infective endocarditis in congenital heart disease. Heart. 2006;92:1490–5.

    Article  Google Scholar 

  21. •• Garg P, Ko DT, Bray Jenkyn KM, Li L, Shariff SZ. Infective endocarditis hospitalizations and antibiotic prophylaxis rates before and after the 2007 American Heart Association guideline revision. Circulation. 2019;140:170–80. This paper outlines the trends in infective endocarditis after the change in antibiotic prophylaxis guideines.

    Article  Google Scholar 

  22. Vogkou CT, Vlachogiannis NI, Palaiodimos L, Kousoulis AA. The causative agents in infective endocarditis: a systematic review comprising 33,214 cases. Eur J Clin Microbiol Infect Dis. 2016;35:1227–45.

    Article  CAS  Google Scholar 

  23. Smith MM, Barbara DW, Mauermann WJ, Viozzi CF, Dearani JA, Grim KJ. Morbidity and mortality associated with dental extraction before cardiac operation. Ann Thorac Surg. 2014;97:838–44.

    Article  Google Scholar 

  24. Nakamura Y, Tagusari O, Seike Y, Ito Y, Saito K, Miyamoto R, et al. Prevalence of periodontitis and optimal timing of dental treatment in patients undergoing heart valve surgery. Interact Cardiovasc Thorac Surg. 2011;12:696–700.

    Article  Google Scholar 

  25. •• Lockhart PB, DeLong HR, Lipman RD, Abt E, Baddour LM, Colvin M, et al. Effect of dental treatment before cardiac valve surgery: systematic review and meta-analysis. J Am Dent Assoc. 2019;150:739–747 e9. This paper outlines the impact of dental treatment prior to valvular heart surgery.

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Cardiology, Kaiser Permanente, 2238 Geary Boulevard 8th Floor, San Francisco, CA, 94115, USA

    Sahar Naderi

  2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Anwar T. Merchant

Authors
  1. Sahar Naderi
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  2. Anwar T. Merchant
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Correspondence to Sahar Naderi.

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Sahar Naderi and Anwar Merchant declare no conflicts of interest relevant to this manuscript.

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This article is part of the Topical Collection on Coronary Heart Disease

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Naderi, S., Merchant, A.T. The Association Between Periodontitis and Cardiovascular Disease: an Update. Curr Atheroscler Rep 22, 52 (2020). https://doi.org/10.1007/s11883-020-00878-0

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