C-reactive protein levels as a cardiovascular risk factor in patients with and without periodontal disease who are undergoing hip and/or knee arthroplasty

Introduction. A number of diseases, including coronary artery disease are now considered as chronic low-grade inflammatory conditions. Their progres- sion is accelerated by other underlying infectious conditions, including periodontal disease. The aim of the study was to assess if periodontal disease is associated with an increased concentration of inflammatory biomarkers in patients scheduled for joint replacement, who represent a group at elevated cardiovascular risk. Materials and methods. The study included patients scheduled for an elective hip and/or knee replacement surgery, who had pre-operative workup made for the assessment of cardiovascular risk factors. All patients were evaluated by an experienced medical professional in order to assess the periodontal disease status. Patient had their blood taken for the assessment of laboratory parameters, including inflammation biomarkers. Results. Among 257 randomized patients (mean age, 67.1 years; women, 63.0%), 154 (59.9%) were scheduled for hip surgery and 103 (40.1%) for knee surgery. Groups divided by the type of procedure did not significantly differ in terms of age, sex distribution or the prevalence of diabetes. There were no differences in baseline laboratory parameters between the groups. When we compared patients with and without periodontal disease, we saw that the disease was present in 94 (36.6%) of patients. Patients with periodontal disease were significantly younger (66.6 ± 13.2 vs. 67.3 ± 11.3 years; p = 0.04) than patients without the disease. Patients with periodontal disease also had a higher average C-reactive protein (CRP) concentration (6.0 ± 10.6 vs. 4.1 ± 6.2 mg/ dL; p <0.001 No difference was found in terms of other laboratory parameters. More details about the study population can be found in table 1. Conclusions. Patients with periodontal disease have significantly higher CRP levels, which represents an underlying inflammatory process. The inflammatory process can be responsible not only for elevated cardiovascular risk but also for impaired joint healing.