Periodontitis and Other Risk Factor for Coronary Artery Disease among Adults: A Case Control Study in Delhi, India

Background: Periodontitis is an extension of inflammation to the supporting tissue of the tooth. Prevalence varies worldwide with a higher prevalence in Asian countries and in India as reported. Literature reports that the sub-gingival microflora and the continuous latent endotoxemia originating from the periodontal pockets is a risk factor for the damage to vascular endothelial integrity, platelet function and blood coagulation leading to periodontal disease playing a role in etiopathogenesis of coronary artery disease and cerebrovascular disease. Aim: To study periodontitis and other risk factor that correlates with CAD among the adult urban population. Settings & Design: Clinic based case control study carried out in medicine and dental outpatient departments (OPD) of Hamdard Institute of Medical Sciences & Research and associated HAH Centenary Hospital, New Delhi. Minimum sample size was calculated to be 140. A 1:3 case to control ratio was taken. Methods & Materials: Periodontal Index (Russell Index) was utilized in our study to grade periodontal health status. Statistical Analysis: The data was analysed using SPSS 21.0 version. Categorical variables were tested for significance using Chi square test and multiple logistic regression was used for predicting the probability of cases with cardiac problems having periodontitis. Results: 30 (21.4%) participants were recruited as cases and 110 (78.6%) as controls. Among the cases the Mean Russell score for case was 3.98 ± 0.70 and control group was 3.11 ± 0.68, respectively. Among the total subjects 76.4% showed a RI score of ≥3 indicative of established destructive and terminal periodontal disease and 23.5% constituted the beginning of destructive periodontal disease. Conclusion: Severity of periodontitis was noted in cases as compared to controls. Findings suggest the relationship between CAD and periodontal disease.