on February 3, 2005
Published online before print February 3, 2005, doi: 10.1161/01.ATV.0000157982.69663.59
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Submitted on January 15, 2004
Accepted on January 11, 2005
Serum Antibody Levels to Actinobacillus actinomycetemcomitans Predict the Risk for Coronary Heart Disease
Pirkko J. Pussinen *;
From the Institute of Dentistry (P.J.P.), University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki; the Research Institute of Public Health (K.N., R.S., J.A.L., J.T.S.), University of Kuopio; the Department of Health and Functional Ability (G.A.), National Public Health Institute, Helsinki; Savonlinna Central Hospital (J.A.L.), Savonlinna; and Oy Jurilab Ltd (J.T.S.), Kuopio, Finland.
* To whom correspondence should be addressed. E-mail: pirkko.pussinen{at}helsinki.fi.
Objective--The association between serum antibody levels to major periodontal pathogens and coronary heart disease (CHD) was analyzed in a prospective population-based study.
Methods and Results--The population comprised 1023 men (aged 46 to 64 years) in the Kuopio Ischemic Heart Disease Study. The subjects with CHD at baseline (n=113) were more often seropositive for Porphyromonas gingivalis IgA (38.9% versus 28.5%, P=0.021) and IgG (60.2% versus 46.7%, P=0.007) than those without CHD. During the 10-year follow-up, 109 men free from CHD at baseline experienced an acute myocardial infarction or CHD death. The men with an end point were more often seropositive for Actinobacillus actinomycetemcomitans IgA (15.5% versus 10.2%, P=0.019) than those who remained healthy. In the highest tertile of A. actinomycetemcomitans IgA-antibodies compared with the lowest one, the relative risk (RR) for an end point adjusted for CHD risk factors was 2.0 (1.2 to 3.3). In the Porphyromonas gingivalis IgA-antibody tertiles, the highest RR of 2.1 (95% confidence interval [CI], 1.3 to 3.4) was observed in the second tertile. All antibody levels correlated positively with the carotid artery intima-media thickness.
Conclusions--High-serum antibody levels to major periodontal pathogens are associated with subclinical, prevalent, and future incidence of CHD. Periodontal pathogens or host response against them may contribute to the pathogenesis of CHD.
Key words: atherosclerosis • cardiovascular diseases • infection • inflammation • periodontitis
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