Treating periodontal disease in patients with myocardial infarction: A randomized clinical trial
Institution:
1. Instituto de Cardiologia do Rio Grande do Sul/ Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Brazil;2. Duke Clinical Research Institute, Durham, NC, USA;3. Federal University of São Paulo (USP), São Paulo, Brazil;4. Brazilian Clinical Research Institute, São Paulo, Brazil;1. RAND Corporation, 4570 5th Avenue, Suite 600, Pittsburgh, PA 15213, USA;2. Bienestar Human Services, Inc., 5326 East Beverly Blvd., Los Angeles, CA 90022, USA;3. RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA;1. Department of Molecular Genetic Diagnostics and Cell Biology, Institute of Pediatrics, Research Center for Children''s Health, 119991 Moscow, Russia;2. Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia;3. Institute for Atherosclerosis, Skolkovo Innovative Center, Moscow 143025, Russia;4. Department of Biophysics, Biological Faculty, Moscow State University, Moscow 119991, Russia;5. Faculty of Medicine, School of Medical Sciences, University of New South Wales, Kensington, Sydney, NSW 2052, Australia;6. School of Medicine, University of Western Sydney, Campbelltown NSW 2560, Australia;1. Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany;2. Institute for Diagnostic and Interventional Radiology and Neuroradiology, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany;3. Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany;4. Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany;5. Institute for Medical Informatics, Biometry, and Epidemiology, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany;6. Institute for Pathophysiology, West-German Heart and Vascular Center Essen, Universitätsklinikum Essen, Universität Duisburg-Essen, Germany;7. Department of Neuroradiology, University Hospital Gießen, Gießen, Germany;8. Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Evangelisches Krankenhaus Mülheim, Germany;9. Department of Mathematics and Technology, Koblenz, University of Applied Science, Remagen, Germany
Abstract:
BackgroundPeriodontitis has been associated with coronary artery disease, but the impact of a periodontal treatment on the endothelial function of patients with a recent ST-segment elevation myocardial infarction (STEMI) was not investigated.MethodsRandomized controlled trial (NCT02543502). Patients admitted between August 2012 and January 2015 were included. Patients were screened during the index hospitalization for STEMI, and those with severe periodontal disease were randomized 2 weeks later to periodontal treatment or to control. The primary endpoint of this trial was the between group difference in the variation of flow-mediated vasodilation (FMD) in the brachial artery assessed by ultrasound from baseline to the 6-month follow-up. Secondary outcomes were cardiovascular events, adverse effects of periodontal treatment and inflammatory markers.ResultsBaseline characteristics were balanced between patients in the intervention (n = 24) and control groups (n = 24). There was a significant FMD improvement in the intervention group (3.05%; p = .01), but not in the control group (?0.29%; p = .79) (p = .03 for the intergroup comparison). Periodontal treatment was not associated with any adverse events and the inflammatory profile and cardiovascular events were not significantly different between both groups.ConclusionsTreatment of periodontal disease improves the endothelial function of patients with a recent myocardial infarction, without adverse clinical events. Larger trials are needed to assess the benefit of periodontal treatment on clinical outcomes.Clinical trial registrationNCT02543502 (https://clinicaltrials.gov/ct2/show/NCT02543502?term=NCT02543502&rank=1).
