skip to main content

The Relationship Between Severity of Periodontitis With the Degree of Atherosclerosis in Ischemic Stroke Patients

*Elisabeth Romana Tikalaka  -  Neurology Resident Medical Faculty Diponegoro University/Dr. Kariadi General Hospital,, Indonesia
Amin Husni  -  Neurology Departement Medical Faculty Diponegoro University / Dr. Kariadi General Hospital, Semarang, Indonesia
Retnaningsih -  -  Neurology Departement Medical Faculty Diponegoro University / Dr. Kariadi General Hospital, Semarang, Indonesia
Dodik Tugasworo  -  Neurology Departement Medical Faculty Diponegoro University / Dr. Kariadi General Hospital, Semarang, Indonesia
Jimmy Eko Budi Hartono  -  Neurology Departement Medical Faculty Diponegoro University / Dr. Kariadi General Hospital, Semarang, Indonesia
Maria Belladonna Rahmawati  -  Neurology Departement Medical Faculty Diponegoro University / National Diponegoro Hospital, Semarang, Indonesia
Iva Puspitasari  -  Microbiology Departement Medical Faculty Diponegoro University / Dr. Kariadi General Hospital, Semarang, Indonesia
Open Access Copyright (c) 2021 Diponegoro International Medical Journal
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Abstract

Background : Periodontal diseases affect up to 80% of the global population. Periodontitis is a long-term inflammatory disease that affects the soft and hard tissues around the teeth. It may also play a role in the pathogenesis of atheroma formation and is associated with cerebrovascular disease. The Carotid Intima Media Thickness (CIMT) is a good marker for detecting early and progressive atherosclerosis. Several hypotheses link chronic infectious diseases, including periodontal tissue disease, to the atherosclerosis process and are risk factors for stroke.

Objective : To determine the relationship between the severity of periodontitis and the degree of atherosclerosis in ischemic stroke.

Methods : This is an analytic observational study with a case-control approach. Subjects were ischemic stroke patients with inclusion criteria. Analyzed the severity of periodontitis with Miller’s Mobility Index (MMI), the degree of progression of atherosclerosis assessed by measuring the CIMT using an ultrasound device or B mode to detect the presence and progression of atherosclerosis.

Results : 54 subjects with a mean age were 63,43 ± 7,19 years, and the dominant sex was male. There was a significant relationship between severity of periodontitis  ( P : 0,011, OR : 3,425, CI 95% 1,332-8,807) and type of profile lipid triglyceride ( P : 0,027, OR : 6,840, CI 95% 1,242-37,676)  to Carotid intima media thickness.

Conclusion :  There is an association between the severity of periodontitis and the degree of atherosclerosis. Severe periodontitis is related to the increases of CIMT, which is a marker of atherosclerosis, a risk factor for stroke.

Fulltext View|Download
Keywords: Ischemic stroke, Atherosclerosis, Periodontitis, Miller 's Mobility Index, Carotid Intima Media Thickness.
Funding: http://creativecommons.org/licenses/by/4.0/

Article Metrics:

  1. Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart disease and stroke statistics - 2018 update: A report from the American Heart Association. Vol. 137, Circulation. 2018. 67–492 p
  2. Feigin VL, Norrving B, Mensah GA. Global Burden of Stroke. Circ Res. 2017;120(3):439–48
  3. Biro Komunikasi dan Pelayanan Masyarakat KKR. Kementerian Kesehatan Republik Indonesia riskesdas stroke 2018
  4. Rasyid Al, Hidayat Rachmat, Harris Salim KM. Buku Ajar neurologi. Departemen neurologi FK UI. Jakarta 2017. Neurol FK UI Jakarta 2017
  5. Sen S, Giamberardino LD, Moss K, Morelli T, Rosamond WD, Gottesman RF, et al. Periodontal Disease, Regular Dental Care Use, and Incident Ischemic Stroke. Stroke. 2018;49(2):355–62
  6. Desvarieux M, Demmer RT, Rundek T, Boden-Albala B, Jacobs DR, Sacco RL, et al. Periodontal microbiota and carotid intima-media thickness: The Oral Infections and Vascular Disease Epidemiology Study (INVEST). Circulation. 2005;111(5):576–82
  7. Palm F, Lahdentausta L, Sorsa T, Tervahartiala T, Gokel P, Buggle F, et al. Biomarkers of periodontitis and inflammation in ischemic stroke: A case-control study. Innate Immun. 2014;20(5):511–8
  8. Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levison ME, et al. Periodontal disease and atherosclerotic vascular disease: Does the evidence support an independent association?: A scientific statement from the American heart association. Circulation. 2012;125(20):2520–44
  9. Sfyroeras GS, Roussas N, Saleptsis VG, Argyriou C, Giannoukas AD. Association between periodontal disease and stroke. J Vasc Surg [Internet]. 2012;55(4):1178–84. Available from: http://dx.doi.org/10.1016/j.jvs.2011.10.008
  10. Toregeani JF, Nassar CA, Toregeani KAM, Nassar PO. Periodontal disease and atherosclerosis. J Vasc Bras. 2014;13(3):208–16
  11. Wu CP, Tu YK, Lu SL, Chang JH, Lu HK. Quantitative analysis of Miller mobility index for the diagnosis of moderate to severe periodontitis - A cross-sectional study. J Dent Sci [Internet]. 2018;13(1):43–7. Available from: https://doi.org/10.1016/j.jds.2017.11.001
  12. Natto ZS, Abu Ahmad RH, Alsharif LT, Alrowithi HF, Alsini DA, Salih HA, et al. Chronic periodontitis case definitions and confounders in periodontal research: A systematic assessment. Biomed Res Int. 2018;2018
  13. Demmer RT, Desvarieux M. Periodontal infections and cardiovascular disease : The heart of the matter. J Am Dent Assoc. 2017;137(10 SUPPL.):S14–20
  14. Benedek T. Review. The Link between Periodontal Disease, Inflammation and Atherosclerosis — an Interdisciplinary Approach. J Interdiscip Med. 2017;2(s1):11–6
  15. de Groot E, van Leuven SI, Duivenvoorden R, Meuwese MC, Akdim F, Bots ML, et al. Measurement of carotid intima-media thickness to assess progression and regression of atherosclerosis. Nat Clin Pract Cardiovasc Med. 2008;5(5):280–8
  16. Qu B, Qu T. Causes of changes in carotid intima-media thickness: a literature review. Cardiovasc Ultrasound [Internet]. 2015;13(1):1–10. Available from: http://dx.doi.org/10.1186/s12947-015-0041-4
  17. Kasliwal R, Bansal M, Desai D, Sharma M. Carotid intima-media thickness: Current evidence, practices, and Indian experience. Indian J Endocrinol Metab. 2014;18(1):13–22
  18. Sahoo R, Krishna MV, Subrahmaniyan DKS, Dutta TK, Elangovan S. Common carotid intima-media thickness in acute ischemic stroke: A case control study. Neurol India. 2009;57(5):627–30
  19. Simon A, Megnien JL, Chironi G. The value of carotid intima-media thickness for predicting cardiovascular risk. Arterioscler Thromb Vasc Biol. 2010;30(2):182–5
  20. Beck JD, Elter JR, Heiss G, Couper D, Mauriello SM, Offenbacher S. Relationship of periodontal disease to carotid artery intima-media wall thickness: The Atherosclerosis Risk in Communities (ARIC) study. Arterioscler Thromb Vasc Biol. 2015;21(11):1816–22
  21. Saxena Y, Saxena V, Mittal M, Srivastava M, Raghuvanshi S. Age-wise association of carotid intima media thickness in ischemic stroke. Ann Neurosci. 2017;24(1):5–11
  22. Dr. J Nugroho Eko P, dr. SpJP(K) FIHA Prof. Dr. Djoko Soemantri dr. SF. HUBUNGAN PENINGKATAN CAROTID INTIMA-MEDIA THICKNESS (CIMT) DAN KEJADIAN KARDIOVASKULAR PADA PENDERITA DENGAN FAKTOR RISIKO KARDIOVASKULAR SEDANG Karya. 2016;
  23. Lafon A, Pereira B, Dufour T, Rigouby V, Giroud M, Béjot Y, et al. Periodontal disease and stroke: A meta-analysis of cohort studies. Eur J Neurol. 2014;21(9):1155–61
  24. Praliya RS, Gupta S, Adya CM, Thakur N, Saini S. A Study of Correlation of Postprandial Lipid Profile with Carotid Intima Media Thickness in Type-II Diabetes Mellitus. 2020;7(August):330–4
  25. Chatterjee, Nimrat Walker G. Association Between Triglyceride Lowering and Reduction of Cardiovascular Risk Across Multiple Lipid-Lowering Therapeutic Classes: A Systematic Review and Meta-Regression Analysis of Randomized Controlled Trials. Physiol Behav. 2017;176(10):139–48. Available from: file:///C:/Users/Carla Carolina/Desktop/Artigos para acrescentar na qualificação/The impact of birth weight on cardiovascular disease risk in the

Last update:

No citation recorded.

Last update:

No citation recorded.