ABC | Volume 114, Nº2, February 2020

Original Article Rocha et al. Association between periodontitis, polymorphisms and CAD Arq Bras Cardiol. 2020; 114(2):268-272 1.09-7.55). These findings are in agreement with authors who investigated the association of this polymorphism with the risk of CAD in 484 Chinese individuals, and found that the IL6 -174 G > C polymorphism was positively associated with the risk of CAD (p = 0.001 OR= 2.18 CI 95%) 1.26 - 3.77), in agreement to our findings, but with a higher statistical significance. 18 In a recent study, 280 patients were analyzed in an attempt to correlate five polymorphisms, among them IL6 -174 G > C, with CAD in a population from northern India. In this analysis, the authors did not find any statistical significance regarding this polymorphism and CAD. 20 Similarly, Brazilian authors analyzed 200 patients with acute coronary syndrome and their association with the presence of the IL6 -174 G > C polymorphism in Pernambuco, Brazil, and found no significant association between the presence of the risk alleles and acute coronary syndrome. 27 The variables that were significant were included in a bivariate logistic regression model with the purpose of adjusting the independence of these associations, verifying which of them would predict CAD. The most uniform model was the one that remained independently associated with CAD, age > 60 years and the presence of the +1444 C > T PCR polymorphism (table 2). Considering the limitation of the type of study (case- control) where the information about the exposure or factor is obtained after the occurrence of the disease and there is no way to differentiate the chronology between the exposure and the disease onset, to determine a direct causal association between periodontitis and CAD becomes more difficult. The fact that this association is present may indicate preventive and curative treatments for the control of periodontitis, aiming to reduce the group of factors that contribute to the formation and development of CAD, besides the known risk factors. Conclusions Based on the analyzed data, it can be concluded that the age over 60 years and the presence of the PCR + 1444 C > T polymorphism were independent predictors associated with coronary artery disease. The presence of periodontitis and male gender did not remain associatedwith CAD after adjusting by logistic regression. Author contributions Conception and design of the research and Obtaining financing: Rocha LO, Brito Junior RB; Acquisition of data: Rocha LO, Rocha E, Brito Junior RB; Analysis and interpretation of the data: Rocha LO, Rocha E, Succi GM, Brito Junior RB; Statistical analysis: Rocha LO, Rocha E; Writing of the manuscript: Rocha LO, Rocha E, Succi GM, Brito Junior RB; Critical revision of the manuscript for intellectual content: Rocha LO, Succi GM, Brito Junior RB. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This article is part of the thesis of Doctoral submitted by Luiz Otávio Rocha, from Centro de Graduação São Leopoldo Mandic . Ethics approval and consent to participate This study was approved by the Ethics Committee of the Centro de Graduação São Leopoldo Mandic under the protocol number CAAE: 35879614.7.0000.5374. 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