Relationship between past myocardial infarction, periodontal disease and Porphyromonas gingivalis serum antibodies: A case-control study

Cardiol J. 2018;25(3):386-392. doi: 10.5603/CJ.a2017.0015. Epub 2017 Feb 2.


Background: The relationship between chronic periodontitis (CP) and increased risk for cardiovas-cular disease (CVD) is known but quantitative assessments and mechanisms are not fully understood. The aim of this study was to assess the relationship between past myocardial infarction (MI) and the severity of CP, and the level of serum antibody titer against Porphyromonas gingivalis gingipains.

Methods: The study sample consisted of 97 patients after MI and 113 high risk controls with no history of coronary heart disease (CHD) matched with age, sex and place of residence (urban vs. rural). Data on the history of CHD and presence of risk factors were collected. Periodontal status was assessed using the Community Periodontal Index (CPI), clinical attachment loss (CAL), bleeding on probing (BOP) and pocket depth.

Results: After adjustment for potential confounders patients with BOP = 20-50% and BOP > 50% had more than four times higher odds of past MI (OR = 4.56; 95% CI 2.03-10.27). Patients with CPI code = 4 had a three times higher odds of past MI (OR = 3.18, 95% CI 1.01-10.06). CAL ≥ 6 was related to higher odds of past MI (OR = 1.28, 95% CI 1.11-1.49). Patients with moderate antibody titer levels had an almost 3 times higher odds of past MI (OR = 2.82, 95% CI 1.02-7.84).

Conclusions: There was an association between CP and past MI, which was independent of classical CVD risk factors and confirmed by an association between past MI and immunological reaction against P. gingivalis gingipains.

Keywords: Porphyromonas gingivalis gingipains; cardiovascular disease risk factors; myocardial infarction; periodontal disease.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / blood*
  • Bacteroidaceae Infections / blood
  • Bacteroidaceae Infections / complications*
  • Bacteroidaceae Infections / microbiology
  • Case-Control Studies
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / etiology*
  • Periodontal Diseases / blood
  • Periodontal Diseases / complications*
  • Periodontal Diseases / microbiology
  • Periodontal Index
  • Poland / epidemiology
  • Porphyromonas gingivalis / immunology*
  • Risk Assessment*
  • Risk Factors


  • Antibodies, Bacterial