Coronary Artery Disease and Periodontal disease –Does severity correlates? An Angiographically confirmed cross-sectional study, Jaipur, India





Coronary artery disease, Periodontitis, Angiogram, Cardiology

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  • Vasim Raja Panwar Rajasthan Dental College and Hospital, Jaipur
  • Abhishek Sharma RUHS College of Dental Sciences (Government Dental College), Jaipur
  • Shashi Mohan Sharma SMS Hospital, Jaipur
  • Sujal Parkar Siddhpur dental college and hospital, Siddhpur, Patan
  • Setu Mathur RUHS College of Dental Sciences, Jaipur
  • Arvind Sharma RUHS College of Medical Sciences, Jaipur


Background: Coronary artery disease is one of the leading causes of death worldwide. Chronic periodontal disease is the most common oral disease. Bacteremia associated with periodontal disease has an impact on vascular components and connective tissues, which in turn may play role in coronary artery disease. Aim: The aim of the study was to assess correlation between severity of coronary artery disease and periodontal disease. Material and methods: Severity of coronary artery disease was assessed by calculating Gensini scores from the coronary angiograms while periodontal status was assessed clinically by using community periodontal index (CPI) and loss of attachment index (LOA) as per WHO methodology 1997 among 700 participants. Results: The average Gensini score was reported as 30.54 ± 22.84. A significant correlation (P<0.05) was found between Gensini score and CPI score 0, 2, 3 and 4. Conclusion: Weak correlation was found between severity of coronary artery disease and periodontitis.

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Vasim Raja Panwar, Abhishek Sharma, Shashi Mohan Sharma, Sujal Parkar, Setu Mathur, Sharma A. Coronary Artery Disease and Periodontal disease –Does severity correlates? An Angiographically confirmed cross-sectional study, Jaipur, India. Indian J Community Health [Internet]. 2020 Dec. 31 [cited 2022 Oct. 3];32(4):731-6. Available from:


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Najafi-Parizi G, Lori A. Periodontal Disease as a Risk Factor for Coronary Artery Disease. Am J Appl Sci. 2005;2 (11): 1526-1528

Mahendra J, Mahendra L, Kurian VM, Jaishankar K, Mythilli R. Prevalence of periodontal pathogens in coronary atherosclerotic plaque of patients undergoing coronary artery bypass graft surgery. J Maxillofac Oral Surg. 2009;8(2):108-13. doi: 10.1007/s12663-009-0028-5. Epub 2009 Aug 11. PMID: 23139486; PMCID: PMC3453943.[PubMed]

Barilli AL, Passos AD, Marin-Neto JA, Franco LJ. Periodontal disease inpatients with ischemic coronary atherosclerosis at a University Hospital. ArqBras Cardiol. 2006;87(6):695-700. English, Portuguese. doi:10.1590/s0066-782x2006001900003. PMID: 17262105.[PubMed]

Armitage GC. Periodontal infections and cardiovascular disease--how strong isthe association? Oral Dis. 2000;6(6):335-50. doi:10.1111/j.1601-0825.2000.tb00126.x. PMID: 11355266.[PubMe].

Armitage GC. Periodontal infections and cardiovascular disease--how strong isthe association? Oral Dis. 2000;6(6):335-50. doi:10.1111/j.1601-0825.2000.tb00126.x. PMID: 11355266.[PubMed]

Ebersole JL, Machen RL, Steffen MJ, Willmann DE. Systemic acute-phase reactants, C-reactive protein and haptoglobin, in adult periodontitis. Clin Exp Immunol. 1997;107(2):347-52. doi: 10.1111/j.1365-2249.1997.270-ce1162.x. PMID: 9030874; PMCID: PMC1904587.[PubMed].

Kweider M, Lowe GD, Murray GD, Kinane DF, McGowan DA. Dental disease, fibrinogen and white cell count; links with myocardial infarction? Scott Med J. 1993;38(3):73-4. doi: 10.1177/003693309303800304. PMID: 8356427.[PubMed].

Noack B, Genco RJ, Trevisan M, Grossi S, Zambon JJ, De Nardin E. Periodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol. 2001;72(9):1221-7. doi: 10.1902/jop.2000.72.9.1221. PMID: 11577954.[PubMed]

Slade GD, Offenbacher S, Beck JD, Heiss G, Pankow JS. Acute-phase inflammatory response to periodontal disease in the US population. J Dent Res. 2000;79(1):49-57. doi: 10.1177/00220345000790010701. PMID: 10690660.[PubMed]

Wu T, Trevisan M, Genco RJ, Falkner KL, Dorn JP, Sempos CT. Examination of the relation between periodontal health status and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen. Am J Epidemiol. 2000;151(3):273-82. doi: 10.1093/oxfordjournals.aje.a010203. PMID: 10670552.[PubMed]

Hujoel PP, Drangsholt M, Spiekerman C, Derouen TA. Examining the link between coronary heart disease and the elimination of chronic dental infections. J Am Dent Assoc. 2001;132(7):883-9. doi: 10.14219/jada.archive.2001.0300. PMID: 11480641.[PubMed].

Howell TH, Ridker PM, Ajani UA, Hennekens CH, Christen WG. Periodontal disease and risk of subsequent cardiovascular disease in U.S. male physicians. J Am Coll Cardiol. 2001;37(2):445-50. doi: 10.1016/s0735-1097(00)01130-x. PMID: 11216961.[PubMed].

Tuominen R, Reunanen A, Paunio M, Paunio I, Aromaa A. Oral health indicators poorly predict coronary heart disease deaths. J Dent Res. 2003;82(9):713-8. doi: 10.1177/154405910308200911. PMID: 12939356.[PubMed]

Oral health survey basic methods. World Health Organization, Geneva. 4th ed. Delhi: AITBS Publisher and Distributors; 1997. p. 16-20

1: Humphrey LL, Fu R, Buckley DI, Freeman M, Helfand M. Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis. J Gen Intern Med. 2008;23(12):2079-86. doi: 10.1007/s11606-008-0787-6. Epub 2008 Sep 20. PMID: 18807098; PMCID: PMC2596495.[PubMed].

Fadel HT, Al-Kindy KA, Mosalli M, Heijl L, Birkhed D. Caries risk and periodontitis in patients with coronary artery disease. J Periodontol. 2011;82(9):1295-303. doi: 10.1902/jop.2011.100655. Epub 2011 Feb 2. PMID: 21284544.[PubMed]

Geerts SO, Legrand V, Charpentier J, Albert A, Rompen EH. Further evidence of the association between periodontal conditions and coronary artery disease. J Periodontol. 2004;75(9):1274-80. doi: 10.1902/jop.2004.75.9.1274. PMID: 15515345.[PubMed].

Glurich I, Grossi S, Albini B, Ho A, Shah R, Zeid M, Baumann H, Genco RJ, De Nardin E. Systemic inflammation in cardiovascular and periodontal disease: comparative study. Clin Diagn Lab Immunol. 2002;9(2):425-32. doi: 10.1128/cdli.9.2.425-432.2002. PMID: 11874889; PMCID: PMC119918.[PubMed]

Joshipura KJ, Wand HC, Merchant AT, Rimm EB. Periodontal disease and biomarkers related to cardiovascular disease. J Dent Res. 2004;83(2):151-5. doi: 10.1177/154405910408300213. PMID: 14742654.[PubMed].

Sahingur SE, Sharma A, Genco RJ, De Nardin E. Association of increased levels of fibrinogen and the -455G/A fibrinogen gene polymorphism with chronic periodontitis. J Periodontol. 2003;74(3):329-37. doi: 10.1902/jop.2003.74.3.329. PMID: 12710752.[PubMed]

Haraszthy VI, Zambon JJ, Trevisan M, Zeid M, Genco RJ. Identification of periodontal pathogens in atheromatous plaques. J Periodontol. 2000;71(10):1554-60. doi: 10.1902/jop.2000.71.10.1554. PMID: 11063387.[PubMed]

Desvarieux M, Demmer RT, Rundek T, Boden-Albala B, Jacobs Jr D, Papapanou PN et al. Relationship between periodontal disease, tooth loss, and carotid artery plaque: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Stroke. 2003;34(9):2120–5

Sharma A, Novak EK, Sojar HT, Swank RT, Kuramitsu HK, Genco RJ. Porphyromonas gingivalis platelet aggregation activity: outer membrane vesicles are potent activators of murine platelets. Oral Microbiol Immunol. 2000;15(6):393-6. doi: 10.1034/j.1399-302x.2000.150610.x. PMID: 11154438.[PubMed]

Mattila KJ, Valle MS, Nieminen MS, Valtonen VV, Hietaniemi KL. Dental infections and coronary atherosclerosis. Atherosclerosis. 1993;103(2):205-11. doi: 10.1016/0021-9150(93)90263-t. PMID: 8292096.[PubMed]

Bazile A, Bissada NF, Nair R, Siegel BP. Periodontal assessment of patients undergoing angioplasty for treatment of coronary artery disease. J Periodontol. 2002;73(6):631-6. doi: 10.1902/jop.2002.73.6.631. PMID: 12083536.[PubMed]

Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesäniemi YA, Syrjälä SL, Jungell PS, Isoluoma M, Hietaniemi K, Jokinen MJ. Association between dental health and acute myocardial infarction. BMJ. 1989;298(6676):779-81. doi: 10.1136/bmj.298.6676.779. PMID: 2496855; PMCID: PMC1836063.[PubMed].

Rutger Persson G, Ohlsson O, Pettersson T, Renvert S. Chronic periodontitis, a significant relationship with acute myocardial infarction. Eur Heart J. 2003;24(23):2108-15. doi: 10.1016/j.ehj.2003.10.007. PMID: 14643271.[PubMed].

Pearson TA, Mensah GA, Alexander RW, Anderson JL, Cannon RO, Criqui M et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107(3):499–511.

Yang J, Feng L, Ren J, Wu G, Chen S, Zhou Q, Du Z, Zhang S, Hu C, Wu X, Ling L. Correlation between the severity of periodontitis and coronary artery stenosis in a Chinese population. Aust Dent J. 2013;58(3):333-8. doi: 10.1111/adj.12087. Epub 2013 Jul 31. PMID: 23981215.[PubMed]

Parkar SM, Modi GN, Jani J. Periodontitis as risk factor for acute myocardial infarction: A case control study. Heart Views. 2013;14(1):5-11. doi: 10.4103/1995-705X.107113. PMID: 23580918; PMCID: PMC3621229.[PubMed]

Sanz M, Marco Del Castillo A, Jepsen S, Gonzalez-Juanatey JR, D'Aiuto F, Bouchard P, Chapple I, Dietrich T, Gotsman I, Graziani F, Herrera D, Loos B, Madianos P, Michel JB, Perel P, Pieske B, Shapira L, Shechter M, Tonetti M, Vlachopoulos C, Wimmer G. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol. 2020;47(3):268-288. doi: 10.1111/jcpe.13189. Epub 2020 Feb 3. PMID: 32011025; PMCID: PMC7027895.[PubMed].

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