Periodontal Status, C-Reactive Protein, NT-proBNP, and Incident Heart Failure: The ARIC Study

Rebecca L. Molinsky, Melana Yuzefpolskaya, Faye L. Norby, Bing Yu, Amil M. Shah, James S. Pankow, Chiadi E. Ndumele, Pamela L. Lutsey, Panos N. Papapanou, James D. Beck, Paolo C. Colombo, Ryan T. Demmer

Résultat de rechercheexamen par les pairs

11 Citations (Scopus)

Résumé

Background: Periodontal disease (PD), resulting from inflammatory host response to dysbiotic subgingival microbiota, has been linked to cardiovascular disease; however, its relationship to heart failure (HF) and its subtypes (heart failure with reduced ejection fraction [HFrEF] and heart failure with preserved ejection fraction [HFpEF]) is unexplored. Objectives: The authors hypothesize that the presence of PD is associated with increased risk of incident HF, HFpEF, and HFrEF. Methods: A total of 6,707 participants (mean age 63 ± 6 years) of the ARIC (Atherosclerosis Risk In Communities) study with full-mouth periodontal examination at visit 4 (1996-1998) and longitudinal follow-up for any incident HF (visit 4 to 2018), or incident HFpEF and HFrEF (2005-2018) were included. Periodontal status was classified as follows: healthy, PD (as per Periodontal Profile Classification [PPC]), or edentulous. Multivariable-adjusted Cox proportional hazards models were used to calculate HRs and 95% CIs for the association between PPC levels and incident HF, HFpEF, or HFrEF. Additionally, biomarkers of inflammation (C-reactive protein [CRP]) and congestion (N-terminal brain natriuretic peptide [NT-proBNP]) were assessed. Results: In total, 1,178 incident HF cases occurred (350 HFpEF, 319 HFrEF, and 509 HF of unknown type) over a median of 13 years. Of these cases, 59% had PD, whereas 18% were edentulous. PD was associated with an increased risk for HFpEF (HR: 1.35 [95% CI: 0.98-1.86]) and significantly increased risk for HFrEF (HR: 1.69 [95% CI: 1.18-2.43]), as was edentulism: HFpEF (HR: 2.00 [95% CI: 1.37-2.93]), HFrEF (HR: 2.19 [95% CI: 1.43-3.36]). Edentulism was associated with unfavorable change in CRP and NT-proBNP, whereas PD was associated only with CRP. Conclusions: Periodontal status was associated with incident HF, HFpEF, and HFrEF, as well as unfavorable changes in CRP and NT-proBNP.

Langue d'origineEnglish
Pages (de-à)731-741
Nombre de pages11
JournalJACC: Heart Failure
Volume10
Numéro de publication10
DOI
Statut de publicationPublished - oct. 2022

Financement

Bailleurs de fondsNuméro du bailleur de fonds
National Institutes of Health
U.S. Department of Health and Human Services75N92022D00003, 75N92022D00004, 75N92022D00001, K24 HL 159246, 75N92022D00002, 75N92022D00005
National Heart, Lung, and Blood InstituteT32HL007779

    ASJC Scopus Subject Areas

    • Cardiology and Cardiovascular Medicine

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