ABSTRACT
Introduction Through plausible biological mechanisms, periodontitis causes systemic inflammatory burden and response, thus resulting in damage far beyond the oral cavity. Studies have demonstrated periodontitis to be a significant risk factor for coronary heart disease (CHD) and stroke. The larger the quantum of periodontal inflamed tissue, the greater the chances of periodontitis eliciting bacteremia and systemic inflammatory responses. Studies have reported that periodontitis and other common oral infections play an important role in the development of atherosclerosis. Therefore, the quantity of inflamed periodontal tissue assumes significance in determining the severity of atherosclerosis. Hence, this study investigates the impact of periodontal inflamed surface area (PISA) on the severity of coronary atherosclerosis. Materials and methods In this cross-sectional study, a total of 160 patients who presented at the department of periodontics of The British University in Egypt (BUE) from 1 January 2023 to 30 September 2023 were enrolled. Patients were only enrolled if they had undergone coronary angiography within the last six months, were less than 60 years of age, shared their previous medical history and coronary angiographic report, and gave informed written consent. Data on classic coronary risk factors and periodontal inflammatory status and angiographic findings were recorded and subjected to appropriate statistical analysis. Results The results revealed that the periodontal inflamed surface area (p = 0.002) apart from age (p < 0.047) and low-density lipoprotein cholesterol (LDL-C) (p < 0.001) is a significant independent predictor of the severity of coronary atherosclerosis. Conclusions The periodontal inflamed surface area is an independent predictor of the severity of coronary atherosclerosis.
ABSTRACT
INTRODUCTION: Myocardial dysfunction is a leading cause of mortality in chronic kidney disease (CKD) children specially those on regular hemodialysis. Cardiac biomarkers play a key role for early detection of myocardial injury. We aim to clarify the prognostic role of circulating cardiac biomarkers, heart type fatty acid binding protein (H-FABP) and pregnancy associated plasma protein-A (PAPP-A) in CKD children on regular hemodialysis. MATERIAL AND METHODS: This is a prospective case control study over 2 years duration. Initial assessment included 20 CKD children on regular hemodialysis and 20 age- and sex- matched healthy children as a control group. Serum level of H-FABP and PAPP-A were measured and correlated to conventional echocardiographic findings and cardiovascular outcome in CKD children. RESULTS: 60% of CKD children developed cardiovascular comorbidities. H-FABP and PAPP-A levels were significantly elevated especially in those with worse cardiovascular outcome. H-FABP and PASP-A levels were positively correlated with LVM index. At cut off point > 17.65 pg/mL, H-FABP has 91% sensitivity and 87.5% specificity for prediction of cardiac morbidity. Elevated H-FABP (OR = 33; CI 95%: 2.455 - 443.591), LVM indexed to body surface area (OR = 21; CI 95%: 1.777 - 248.103), LVM indexed to lean body mass (OR = 15; CI 95%: 1.652 -136.172), elevated PAPP-A (OR = 9.8; CI 95%: 0.898 - 106.845) and Hypertension (OR = 8.333; CI 95%: 1.034 - 67.142) are the main risk factors for cardiac morbidities in CKD children. CONCLUSIONS: Elevated H-FABP and PAPP-A are valuable prognostic markers for cardiovascular outcome in CKD children on regular hemodialysis.
