Subgingival Aggregatibacter actinomycetemcomitans associates with the risk of coronary artery disease

Mäntylä, Päivi; Buhlin, Kåre; Paju, Susanna; Persson, G. Rutger; Nieminen, Markku S.; Sinisalo, Juha; Pussinen, Pirkko J. (2013). Subgingival Aggregatibacter actinomycetemcomitans associates with the risk of coronary artery disease. Journal of clinical periodontology, 40(6), pp. 583-590. Wiley 10.1111/jcpe.12098

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AIM

We investigated the association between angiographically verified coronary artery disease (CAD) and subgingival Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola.

MATERIALS AND METHODS

The cross-sectional study population (n = 445) comprised 171 (38.4%) patients with Stable CAD, 158 (35.5%) with acute coronary syndrome (ACS) and 116 (26.1%) with no significant CAD (No CAD). All patients participated in clinical and radiological oral health examinations. Pooled subgingival bacterial samples were analysed by checkerboard DNA-DNA hybridization assays.

RESULTS

In all study groups, the presence of P. gingivalis, T. forsythia and T. denticola indicated a significant (p ≤ 0.001) linear association with the extent of alveolar bone loss (ABL), but A. actinomycetemcomitans did not (p = 0.074). With a threshold level of bacterial cells 1 × 10(5) A. actinomycetemcomitans was significantly more prevalent in the Stable CAD group (42.1%) compared to the No CAD group (30.2%) (p = 0.040). In a multi-adjusted logistic regression analysis using this threshold, A. actinomycetemcomitans positivity associated with Stable CAD (OR 1.83, 95% CI 1.00-3.35, p = 0.049), but its level or levels of other bacteria did not.

CONCLUSIONS

The presence of subgingival A. actinomycetemcomitans associates with an almost twofold risk of Stable CAD independently of alveolar bone loss.

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