Periodontal Disease and Acute Coronary Syndrome

The presence of specific bacteria and combinations of bacteria in the spaces between the teeth and the gums might explain the apparent relationship between periodontal disease and acute coronary syndrome (ACS), according to a study published recently in the Journal of Periodontology.

Researchers from Sweden, Switzerland and the United States evaluated 161 subjects diagnosed with ACS and a control group of 161 matched subjects who did not have ACS. They studied the subjects' serum white blood cell counts, high- and low-density lipoprotein levels, high-sensitivity C-reactive protein levels, and clinical periodontal health. They also assayed the subjects' subgingival (below the gumline) pathogens.

Researchers found that the amount of oral bacteria was two times higher in the ACS group for the combination of the bacteria streptococci species Porphyromonas gingivalis, Tannerella forsythensis and Treponema denticola. Specifically, the findings suggest that the bacteria shared a common relationship to periodontitis and ACS.

"This might be one of several explanations as to why elevated bacteria and the combination of specific pathogens in periodontal pockets can be linked to a history of ACS," said lead author Dr. Stefan Renvert, Department of Health Sciences, Kristianstad University, Sweden. "We also found that the amount of periodontal bacteria results in an inflammatory response that elevates the white blood cell counts and high-sensitivity C-reactive protein levels, which has also been linked in past studies to heart disease."

Researchers also found that the extent of bone loss in the jaw was significantly greater among subjects in the ACS group. Seventy-seven percent of the subjects in the ACS group and 42 percent of subjects in the control group had evidence of periodontitis. The extent of bone loss was more severe in the ACS group than it was in the control group.

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