Association between periodontal pathogens from the red complex and inflammation in patients with acute coronary syndromes

Abstract Funding Acknowledgements Type of funding sources: None. Background Periodontal disease (PD) is an inflammatory condition that increases cardiovascular risk and favours development of acute coronary events; however, the association of periodontal pathogens and inflammatory markers in patients with acute coronary syndromes (ACS) has not been elucidated so far. Purpose the aim of this study was to evaluate the association between periodontal pathogens of the red and orange complex and inflammatory biomarkers in patients with ACS. Methods Sixteen patients with ACS and concomitant PD were enrolled in the present study. All patients underwent a complex dental examination, including DNA sampling collection from the periodontal pocket. The study population was divided into two groups according to the presence of germs from red, respectively orange complex: group 1 – 9 patients with germs from red complex (RC group) and group 2 – 7 patients with germs from red-orange complex (ROC group). Inflammatory status was assessed on the basis of interleukine 6 (IL6), endothelial/ intravascular adhesion molecules (VCAM/ICAM), P-selectin, metalloproteinase (MMP9), Albumin (Ab), Apolipoprotein B (ApoB), C reactive protein (CRP), alkaline phosphatase (AF) and sST2 and lymphocytes to monocytes ratio. Results Germs from red complex (Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola) were more frequent and more expressed compared with those from orange complex (p=0.0008). There was no significant correlation between RC and RCO group and inflammatory markers; however, P-selectin level (185,4 ± 66,73 vs 89,62 ± 40,94 ng/ml, p=0.005) was higher in RC group, while AF level at baseline (47,83 ±12,53 vs 75,72 ±24,42 UI/l, p=0.006) and in day 7 (52,83 ± 6,122 vs 70,95 ± 9,71 UI/l, p =0.01) was more expreesd in ROC group. A significantly higher lymphocytes to monocytes ratio was identified in patients with ROC compared with those with RC only (3,2 ± 1,44 vs 10,94 ± 12,75, p=0.01). Conclusions in patients with ACS and PD, the presence of germs from red complex in the gingival pocket is associated with increased blood vulnerability. The severity of the PD, expressed by the presence of germs of the red complex, is associated with a higher risk of developing acute coronary events.