Enfermedad periodontal en pacientes con síndrome coronario agudo / Periodontal disease among patients with acute coronary syndrome

Background: Epidemiological studies suggest an association between periodontal disease and coronary heart disease. It is possible that periodontal disease may contribute to plaque destabilization in patients with acute coronary syndrome. Aim: To assess the association between severity of periodontal disease, the number of acute plaques and extension of coronary artery disease in patients with acute coronary syndrome. Patients and methods: The severity of periodontal disease was assessed by skilled independent observers in patients with acute coronary syndrome subjected to coronary angiography. The periodental disease was classified as mild or severe. Acute plaques were defined on angiography as those with thrombi, ulcers or flow alterations. The extension of coronary disease was analyzed using the Sullivan score. Results: Forty three patients (35 males) aged 41 to 83 years, were studied. Mild and severe periodontal disease was present in 18 (42percent) and 25 (58percent) patients respectively. Seventy six percent of those with severe disease had two or more acute plaques, compared with 17percent of those with mild disease (p<0.001). Median Sullivan score was 80.6 and 57.2 in patients with severe or mild periodontal disease respectively (p=0.001). Conclusions: Severe periodontal disease was associated with a higher number of acute coronary plasques and a higher extension of coronary artery disease, in patients with acute coronary syndromes.

Periodontitis y enfermedad cardiovascular ateroesclerótica / Periodontitis and atherosclerotic cardivascular disease

Los factores de riesgo tradicionales como la hipertensión, dislipidemia, diabetes, tabaquismo, etc., no explican la etiología y patogénesis de las complicaciones de la aterosclerosis en todos los pacientes, motivo por el cual la etiología infecciosa de esta patología ha recibido gran atención últimamente. La periodontitis, infección crónica producida por bacterias Gram (-), se ha relacionado con las enfermedades cardiovasculares ateroscleróticas. Ambas patologías comparten factores de riesgo y mecanismos patogénicos que explicarían la posible asociación entre ellas. La presencia de un gran reservorio de bacterias y mediadores inflamatorios relacionados con la periodontitis, son los posibles mecanismos biológicos que relacionan ambas patologías, y la base para la hipótesis de que la periodontitis es un posible factor de riesgo para las enfermedades cardiovasculares ateroscleróticas