Evidence linking the role of periodontal viruses in coronary artery disease with and without periodontitis

J Periodontol. 2021 Jan;92(1):113-122. doi: 10.1002/JPER.19-0704. Epub 2020 Jul 1.

Abstract

Background: Viruses are considered to be a newer family associated with inflammatory diseases. Yet the role of periodontal viruses in coronary artery diseases (CAD) remains unclear. Thus, the current study aims to evaluate the prevalence of periodontal viruses and compare the same in cardiac samples of CAD patients with and without periodontitis.

Methods: A total of 60 patients with CAD indicated for coronary artery bypass graft surgery (CABG) were included. These were grouped into 36 patients with healthy periodontium (CAD only) and 24 patients with periodontitis (CAD + P). The demographic variables, cardiac parameters and periodontal parameters were recorded. Cardiac tissue samples were collected during the CABG surgery and were analyzed by reverse transcriptase polymerase chain reaction for periodontal viruses such as Epstein-Barr virus (EBV), cytomegalovirus (CMV) and Herpes simplex virus. All the parameters were statistically analyzed.

Results: Among the demographic variables, age was statistically significant between the groups. Plaque index, bleeding index, probing depth, and clinical attachment level (CAL) were significantly higher in CAD+P group (P ˂0.05). Periodontal viruses such as EBV and CMV were significantly higher (62.5% and 75% respectively, P ˂0.05) in the cardiac samples of the CAD+P than CAD only (25% and 47.2%, respectively). A significant association between EBV and CAL was revealed by multiple logistic regression analysis. (B = 0.374, P = 0.046) CONCLUSIONS: The results revealed a higher prevalence of periodontal viruses such as EBV and CMV in CAD patients with periodontitis suggesting it as one of the risk factors for CAD. This is supported by the fact that severity of periodontal disease (CAL) is associated with the presence of EBV in coronary artery plaque samples in the current study.

Keywords: cardiovascular disease(s); cytomegalovirus; herpes simplex virus; periodontal medicine; periodontal-systemic disease interactions; periodontitis.

MeSH terms

  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / epidemiology
  • Cytomegalovirus
  • Epstein-Barr Virus Infections*
  • Herpesvirus 4, Human
  • Humans
  • Periodontitis* / complications
  • Periodontitis* / epidemiology