ROLE OF PERIODONTAL INFLAMMATION IN AGGRAVATING CARDIOVASCULAR EVENTS AMONG CORONARY ARTERY DISEASE PATIENTS: A META-ANALYSIS

Abstract

Background: Coronary artery disease (CAD) is a leading cause of morbidity and mortality globally, with inflammation playing a central role in its progression. Evidence suggests that periodontal disease, a chronic inflammatory condition affecting gum tissues, is linked to systemic inflammation markers such as C-reactive protein (CRP) and interleukin-6 (IL-6), which are established CAD risk factors. This meta-analysis explores the association between periodontal inflammation and cardiovascular events in CAD patients, underscoring the importance of oral health in reducing cardiovascular risk.

Objective: To evaluate the relationship between periodontal inflammation and cardiovascular events in CAD patients and to synthesize current literature for clinical implications.

Methods: A comprehensive literature search was conducted in PubMed, Scopus, and Google Scholar using predefined Medical Subject Headings (MeSH) and keywords, including "periodontal inflammation," "cardiovascular events," and "CAD." Studies were selected based on predefined inclusion criteria focusing on CAD patients with periodontal inflammation and cardiovascular outcomes. Data extraction included study characteristics, periodontal measures, cardiovascular outcomes, and inflammatory markers. A random-effects model was used to account for heterogeneity across studies.

Results: Ten studies met inclusion criteria, with sample sizes ranging from 500 to 2000 participants and various study designs. Findings revealed a strong association between periodontal disease and cardiovascular outcomes, particularly myocardial infarction (MI), with odds ratios (OR) ranging from 1.50 to 2.20. Subgroup analysis showed case-control studies reporting stronger associations, with significant heterogeneity across studies (Q = 152.77, I² = 86.3%). Egger’s test indicated potential publication bias (p = 0.013), suggesting further validation is needed.

Conclusion: This analysis indicates a significant association between periodontal inflammation and elevated cardiovascular risk in CAD patients. Incorporating periodontal health monitoring into CAD management could provide a comprehensive approach to reducing cardiovascular complications. Further research is recommended to assess the potential benefits of routine periodontal care in CAD prevention.