Deteriorated clinical outcome in coronary artery disease patients with a high prevalence of Porphyromonas gingivalis infection

Abstract

Background

Porphyromonas gingivalis (P. gingivalis) is known as the main pathogen to progress periodontitis. The aim of this study was to clarify oral infection P. gingivalis in patients with coronary computed tomography angiography (CTA) diagnoses.

Methods

The subjects were 50 consecutive patients who were examined by coronary CTA. Their saliva was examined for the presence of P. gingivalis by 16S rRNA-based polymerase chain reaction. The subjects were divided into 3 groups: normal coronary artery (group NC), patients with coronary plaque but without history of acute coronary syndrome (ACS) (group CP), and post-ACS (group pACS) according to their findings on CT and medical history. We assessed coronary risk factors and C-reactive protein (CRP) levels. Their medical records for the last 5 years were analyzed.

Results

P. gingivalis infection was observed in 37.5% NC (N = 16), 65.2% of the CP (N = 23), and 90.9% of the pACS patients (N = 11). CRP levels in patients with P. gingivalis infection were higher than in those without the infection (0.22 ± 0.30 vs 0.07 ± 0.10 mg/dL; p = 0.031). Multiple regression analysis revealed that P. gingivalis (p = 0.047) was statistically correlated with coronary artery disease (CAD), as well as other coronary risk factors. The patients with a P. gingivalis infection exhibited lower event free survival ratio (p = 0.0348).

Conclusions

P. gingivalis was identified by sensitive detection in patients with CAD, diagnosed by coronary CTA. P. gingivalis in oral saliva can be a potential marker which is associated with clinical outcomes in patients with CAD.