Title Povezanost parodontitisa s angiografski dokazanom koronarnom bolesti srca, klasificiranom prema „SYNTAX“ izračunu rizika Title (english) The association between periodontitis and angiographically verified coronary artery disease as classified by the „SYNTAX“ Score Author Domagoj Vražić Mentor Darije Plančak (mentor)Mentor Maja Strozzi (komentor)Committee member Hrvoje Brkić (predsjednik povjerenstva)Committee member Davor Miličić (član povjerenstva)Committee member Darko Božić (član povjerenstva)Committee member Hrvoje Pintarić (član povjerenstva)Committee member Nataša Beader (član povjerenstva)Granter University of Zagreb Defense date and country 2015-05-14, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 616.31 - Stomatology Abstract Povezanost parodontnih i kardiovaskularnih bolesti intenzivno se istražuje posljednjih godina. Cilj predloženog istraživanja bio je utvrditi učestalost agresivnog i kroničnog parodontitisa kod ispitanika kod kojih je angiografski potvrđena koronarna bolest srca te rezultate usporediti s promjenama kod ispitanika s urednim koronarografskim nalazom. Kod ispitanika analizirao se iznos SYNTAX izračuna rizika (Sinergija između perkutane koronarne intervencije uz upotrebu Taxus stenta i kardijalne kirurgije) i usporedio se s parodontološkim statusom. Ispitanike su činili hospitalizirani bolesnici Kliničkog bolničkog centra Zagreb kojima je zbog boli u prsima napravljena koronarna angiografija.
Temeljiti klinički pregled sastojao se od bilježenja parodontoloških indeksa te kliničkih i socio-demografskih parametara. Ispitanici su bili podijeljeni u dvije skupine: ispitivane - akutni koronarni sindrom (ACS) i stabilna koronarna arterijska bolest (CAD), te kontrolnu – bez značajne koronarne arterijske bolesti. Istraživanje se bazira na pretpostavci da kronične infekcije mogu biti predisponirajući faktor za razvoj aterosklerotskih kardiovaskularnih bolesti te samim time i koronarne bolesti srca, kao i komplikacija koronarne bolesti. Kod pacijenata se u uzorku venske krvi određivao visoko osjetljivi C-reaktivni protein (hsCRP), glukoza, lipidogram te prisutnost specifičnih protutijela na Cytomegalovirus (CMV) i Epstein–Barr virus (EBV). Podaci su analizirani pomoću Kruskal-Wallis i Pearson hi-kvadrat testa.
Povezanost agresivnog i kroničnog parodontitisa i ozbiljnosti koronarne bolesti srca prikazane SYNTAX izračunom rizika bila je značajna, P=0,003. Kod parodontne bolesti i fizičke komponente kvalitete života izrazito se vidi porast odgovarajuće kvalitete u zdravih ispitanika (P=0,008), dok je psihička komponenta značajno zastupljenija kod akutnog koronarnog sindroma u odnosu na ostale. Biokemijski nalazi periferne krvi nisu pokazali značajnu razliku za hs-CRP. Prema parodontnoj bolesti značajna je razlika u razini triglicerida (P=0,020) i HDL-kolesterola (P=0,008), dok prema SYNTAX izračunu rizika značajna je bila razlika kod razine leukocita (P=0,012), neutrofila (P=0,004) i triglicerida (P=0,019). Svi naši ispitanici imali prethodnu infekciju EBV-om, te velika većina naših ispitanika imala je prethodnu infekciju s CMV-om.
Ovo istraživanje je pokazalo da je parodontitis povezan s angiografski potvrđenom koronarnom arterijskom bolesti. Tjelesna neaktivnost, loša oralna higijena i parodontna upala zabilježena je kod bolesnika s ACS i stabilnom CAD.
Abstract (english) Association between periodontal and cardiovascular diseases has been intensively investigated in recent years. The aim of this research was to determine the prevalence of aggressive and chronic periodontitis in patients who had angiographically verified coronary heart disease and also to compare the changes in patients with normal coronary angiographic findings. SYNTAX Score (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) was calculated for every patient and compared with the periodontal status. Subjects were selected among the hospitalized patients at the University Hospital Centre Zagreb who had coronary angiography done because of the chest pain.
Thorough clinical examination included periodontal indices and clinical and socio-demographic characteristics of participants. Subjects were divided in two test groups, acute coronary syndrome (ACS) and stable coronary artery disease (CAD), and the control group with no significant CAD. The research is based on the assumption that chronic infection may be a predisposing factor for the development of atherosclerotic cardiovascular disease, and therefore coronary heart disease and complications of coronary artery disease. In patients' peripheral blood sample a biochemical analysis was performed to determine hs-CRP, glucose, lipid levels, and presence of specific antibodies for Cytomegalovirus (CMV) and Epstein–Barr virus (EBV). Data were analyzed using Kruskal-Wallis and Pearson’s Chi-Square test.
The association of aggressive and chronic periodontitis with the severity of coronary heart disease presented by SYNTAX Score was significant, P=0.003. We found a significant increase of physical quality of life in periodontally healthy patients (P=0.008), while the mental component was significantly more prevalent in patients with acute coronary syndrome. Biochemical analysis of peripheral blood showed no significant difference in hs-CRP. When compared to periodontal disease there was significant difference in the level of triglycerides (P=0.020) and HDL-cholesterol (P=0.008), while when compared to the severity of coronary heart disease presented by SYNTAX Score there was significant difference in levels of leukocytes (P=0.012), neutrophils (P=0,004) and triglycerides (P=0.019). All of our participants have had previous infection with EBV and most of our participants have had previous infection with CMV.
This study showed that periodontitis is associated with angiographically verified coronary artery disease. Physical inactivity, poor oral hygiene and periodontal inflammation were observed in patients with ACS and stable CAD.
Keywords
parodontitis
parodontološki indeksi
kardiovaskularne bolesti
koronarna arterijska bolest
koronarna angiografija
Keywords (english)
Periodontitis
Periodontal Index
Cardiovascular Diseases
Coronary Artery Disease
Coronary Angiography
Language croatian URN:NBN urn:nbn:hr:127:793342 Study programme Title: dental medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2017-04-20 10:02:03
