IJCS | Volume 32, Nº1, January/ February 2019

DOI: 10.5935/2359-4802.20180074 35 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(1)35-40 Mailing Address: Marina Bragheto Oliveira Rua Couto Magalhães, 888. Postal Code: 14400-020, Jardim São Vicente, Franca, SP - Brazil. E-mail: m.bragheto@gmail.com , gabrielricci8@gmail.com Impact of Periodontal Disease on Late Morbimortality (10 Years) of Pacientes with Acute Coronary Syndrome Luis Lemos Moras, Thamara Angeliny Carvalho, Marina Bragheto Oliveir a, Gabriel Andrey Ricci, Renata Accarini, Moacir Fernandes de Godoy Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP - Brazil Manuscript received July 29, 2017; revised manuscript April 09, 2018; accepted May 14, 2018. Abstract Background: It is known that predisposing factors for periodontal disease (PD) and cardiovascular diseases are similar, just as dissemination of oral flora pathogens can induce the development of cardiovascular diseases, which play a direct role on the morbimortality of patients. Objective: To assess the impact of periodontal disease in the presence of acute coronary syndrome on late morbimortality after long-term follow-up of patients (10 years). Methods: The historical prospective study of continuous assessment was based on the evaluation of 345 medical records of patients hospitalized for acute coronary syndrome, divided into 3 groups: edentulous, with periodontal disease and without periodontal disease. The patients studied were in the ICU, in 2006, with a clinical picture of acute coronary syndrome submitted to invasive stratification with coronary angiography on the basis of clinical indication and were reassessed over the next 10 years. The qualitative variables were compared using the Chi- square test. Long-term mortality was assessed using the Kaplan-Meier curves, quantified with the hazard ratio (HR) and a confidence interval of 95% and compared through Cox regression. P values of less than or equal to 0.05 were regarded as statistically significant. Results: Of the 345 patients, 233 had at least one coronary obstruction greater than or equal to 50%, being the main group for comparison according to the different status of periodontal disease (without periodontal disease, with periodontal disease and edentulous). In this cardiovascular condition, we found a difference in mortality among edentulous patients compared to those free of periodontal disease, with a p = 0.004 and a hazard ratio of 10.496 (95% CI: 4.988-22.089). A significant difference was also noted between edentulous patients and patients with periodontal disease, with a p = 0.0017 and a hazard ratio of 2.512 (95% CI: 1.491-4.234). Conclusion: A significant increase in mortality was found according with the progression of periodontal disease, which justifies its classification as an important risk factor for the development of cardiovascular diseases, as well as the need for prevention and treatment of oral diseases. (Int J Cardiovasc Sci. 2019;32(1)35-40) Keywords: Periodontal Diseases/complications; Acute Coronary Syndrome/mortality; Dental Plaque; Gengivitis, Plaque Atherosclerotic. Introduction Cardiovascular diseases (CVD) are characterized as chronic or acute changes in the heart and blood vessels, such as angina, acute myocardial infarction and stroke, being responsible for 24.9% of the deaths registered in Brazil, according to data from the Health Ministry (MS, 2011). 1 The main theory regarding the etiology of CVDs is the atherosclerotic plaque formation within arterial territory due to an inflammatory process associated with the deposition of toxins and organic materials. Thus, the direct presence of bacteria in the atheroma plaque and/ or its toxins affect synergistically the integrity of the endothelium, 2 and diseases that cause bacteremia, such as the periodontal disease (PD), can promote this process.