Is periodontitis a predictor for an adverse outcome in patients
undergoing coronary artery bypass grafting (CABG)?
Abstract
Background: Periodontitis is a risk factor for atherosclerosis and
coronary heart disease (CHD). This research evaluated the relationship
between periodontal conditions and postoperative outcome in patients
undergoing coronary artery bypass grafting (CABG). Methods: 101 patients
with CHD (age 69 years, 88.1 % males) and the necessity of a CABG
surgery were included. Periodontal diagnosis was made according to the
current classification of periodontal diseases (2018) and the guidelines
of the “Centers for Disease Control and Prevention” (2007).
Additionally, periodontal epithelial surface area (PESA) and periodontal
inflamed surface area (PISA) were determined. Survival analyses were
carried out after a one-year follow-up period with Kaplan-Meier survival
plots and Logrank test. Hazard ratios (HRs) were determined using Cox
regression. Results: 14 patients (13.9 %) suffered from a new
cardiovascular event (11 x angina pectoris, 2 x cardiac decompensation,
1 x cardiac death). Patients with an event reported significantly more
often tooth loss probably caused by periodontitis among 1st degree
relatives, (HR = 2.2, 95 % CI 1.1-4.4, p = 0.006). No other
periodontological parameter was significantly associated with the
outcome. Internal risk factors were a history of peripheral arterial
disease (HR = 3.7, 95 % CI 1.-11.4, p = 0.013), history of myocardial
infarction (HR = 4.0, 95 % CI 1.4-11.5, p = 0.006) and borderline
significant previous atrial fibrillation (HR = 2.9, 95 % CI 0.9-9.4, p
= 0.056). Conclusion: Putative familial aggregation of periodontitis but
not severity of the disease was associated with new adverse events after
CABG surgery.