Severe Periodontitis is Associated With Recurrent Cardiovascular Events—A 10‐Year Longitudinal Cohort Study

AIM: The study aimed to elucidate a putative association between severe periodontitis and the incidence of recurrent cardiovascular events in patients with cardiovascular disease (CVD) within 10 years after their initial hospitalisation. METHODS: A cohort of 1002 stationary patients with angiographically proven CVD was included. They were examined regarding prevalence of severe periodontitis (≥ 30% of the teeth with proximal attachment loss of ≥ 5 mm), probing depth, clinical attachment loss, bleeding on probing, number of missing teeth and oral care habits. Recurrent events were summarised as combined end point (myocardial infarction, stroke/transitory ischemic attack, cardiovascular death and death caused by stroke). Survival analyses were carried out after a 10-year follow-up period. Hazard ratios (HRs) were adjusted for known cardiac risk factors using Cox regression. RESULTS: The follow-up was completed by 792 patients. The overall incidence of the combined end point was 42.8%. Severe periodontitis was associated with recurrent cardiovascular events (adjusted hazard ratio [HR] = 1.26, 95% confidence interval [CI] 1.0-1.58 and Standard error [SE] 0.11), whereas both, tooth brushing more than once a day (adjusted HR = 0.74, 95% CI 0.57-0.97, SE 0.13) and performing interdental hygiene (adjusted HR = 0.71, 95% CI 0.52-0.99, SE 0.16) decreased this risk. CONCLUSIONS: Severe periodontitis is a putative risk factor for recurrent cardiovascular events. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01045070.