Periodontitis Progression During Cardiac Rehabilitation After Acute Coronary Syndrome: Cohort Study.

Objectives: To assess changes in periodontal status and factors related to periodontitis progression in acute coronary syndrome patients who undergo a cardiovascular rehabilitation program following an acute coronary incident.

Materials and methods: Fifty-two acute coronary syndrome patients with periodontitis were evaluated during a six-month follow-up period. Periodontal indices were taken at baseline and at 3 and 6 months. Progression of periodontitis was established as clinical attachment loss > 3 mm in two or more teeth at nonadjacent sites. Baseline clinical conditions, microbiological concentration of subgingival biofilm, and risk factors for cardiovascular disease were associated with the incidence of periodontitis progression by a linear mixed-effects model.

Results: 57.69% of the patients had severe periodontitis upon admission, and 64.58% presented a progression of periodontitis during the follow-up periods. Hypertension, low HDL, and high levels of T. forsythia in patients with elevated total cholesterol were the best predictors of clinical attachment loss, with a predictability of 99%. At 6 months, 35.41% of patients' high-sensitivity C-reactive protein (hs-CRP) levels remained over the cardiovascular risk range.

Conclusions: Periodontal condition deterioration was observed. Hypertension and poor metabolic control were associated with the progression of periodontitis. T. forsythia was the most critical local factor in periodontitis progression.