Periodontal disease and myocardial infarction risk: A meta-analysis of cohort studies

Am J Emerg Med. 2021 Oct:48:103-109. doi: 10.1016/j.ajem.2021.03.071. Epub 2021 Apr 8.


Introduction: The objective of this meta-analysis was to systematically assess the association between periodontal disease (PD) and myocardial infarction (MI).

Methods: We searched the EMBASE, PubMed, and Cochrane Library databases for eligible cohort studies from inception to August 31st, 2020 that reported the association between PD and MI. Data extraction was conducted after screening the literature. The risk of bias of the included studies was evaluated by using the Newcastle-Ottawa Scale (NOS). The combined OR value and 95% confidence interval (CI) were calculated by using STATA 11.0 software, and the source of any heterogeneity was determined by performing subgroup analysis and sensitivity analysis.

Results: A total of 10 cohort studies involving 5,369,235 participants fulfilled the inclusion criteria. The meta-analysis showed an increased risk for MI in patients with PD [RR = 1.13, 95% CI (1.04, 1.21), P = 0.004], and this result was robust according to sensitivity analysis. Subgroup analyses indicated that the results were affected by sex, effect value, study quality, survey form and investigation type.

Discussion: This meta-analysis suggests that PD is modestly associated with MI, especially in women, which is similar to the conclusions of earlier meta-analyses of case-control or observational studies. PD may be an untraditional risk factor for cardiovascular diseases, including MI; thus, maintaining periodontal health may be an effective measure to prevent MI. More cohort studies are still needed to further explore the relationship between the incidence of MI and PD.

Keywords: Cohort studies; Meta-analysis; Myocardial infarction; Periodontal disease.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Cohort Studies
  • Humans
  • Myocardial Infarction / etiology*
  • Odds Ratio
  • Periodontal Diseases / complications*
  • Risk Factors