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Periodontal Disease, Atrial Fibrillation and Stroke.

TitlePeriodontal Disease, Atrial Fibrillation and Stroke.
Publication TypeJournal Article
Year of Publication2021
AuthorsSen S, Redd K, Trivedi T, Moss K, Alonso A, Soliman EZ, Magnani JW, Chen LY, Gottesman RF, Rosamond W, Beck J, Offenbacher S
JournalAm Heart J
Volume235
Pagination36-43
Date Published2021 May
ISSN1097-6744
Abstract

BACKGROUND: We recently described the association between periodontal disease (PD) and stroke risk.

PURPOSE: The purpose of this study was to test the association between PD, dental care utilization and incident atrial fibrillation (AF), as well as AF as a mediator to PD- stroke association.

METHODS: In dental cohort of the Atherosclerosis Risk in Communities Study (ARIC), participants without prior AF underwent full-mouth periodontal measurements. PD was defined on an ordinal scale as healthy (referent), mild, moderate and severe. In ARIC main cohort, participants were classified as regular or episodic dental care users. These patients were followed for AF, over 17 years. Cox proportional hazards models adjusted for AF risk factors were used to study relationships between PD severity, dental care utilization and AF. Mediation analysis was used to test if AF mediated the PD- stroke association.

RESULTS: In dental ARIC cohort, 5,958 were assessed without prior AF, 754 were found to have AF. Severe PD was associated with AF on both univariable (crude HR, 1.54; 95% CI, 1.26-1.87) and multivariable (adjusted HR, 1.31, 95% CI, 1.06-1.62) analyses. Mediation analysis suggested AF mediates the association between PD and stroke. In the main ARIC cohort, 9,666 participants without prior AF were assessed for dental care use, 1558 were found to have AF. Compared with episodic users, regular users had a lower risk for AF on univariable (crude HR, 0.82, 95% CI, 0.74-0.90) and multivariable (adjusted HR, 0.88, 95% CI, 0.78-0.99) analyses.

CONCLUSIONS: PD is associated with AF. The association may explain the PD-stroke risk. Regular users had a lower risk of incident AF compared with episodic users.

DOI10.1016/j.ahj.2021.01.009
Alternate JournalAm Heart J
PubMed ID33503409
Grant List16EIA26410001 / AHA / American Heart Association-American Stroke Association / United States
K24 HL148521 / HL / NHLBI NIH HHS / United States