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Major Adverse Cardiovascular Events in Treated Periodontitis: A Population-Based Follow-Up Study from Taiwan.

Chou SH, Tung YC, Lin YS, Wu LS, Lin CP, Liou EJ, Chang CJ, Kung S, Chu PH - PLoS ONE (2015)

Bottom Line: After propensity score matching, 27,146 patients were preserved for comparison, including 13,573 patients with mild form and 13,573 patients with severe form of treated periodontitis.After adjustment for gender, hyperlipidemia, hypertension and diabetes mellitus, severe treated periodontitis was associated with a mildly but significantly increased risk of MACE among older patients > 60 years of age (incidence rate ratio, 1.26; 95% confidence interval, 1.08-1.46).No association was found among younger patients ≤ 60 years of age.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.

ABSTRACT

Background: The aim of the present study was to identify the long-term major adverse cardiovascular events (MACE) in treated periodontitis patients in Taiwan.

Methods: From the National Health Insurance Research Database (2001-2010), adult patients (≥ 18 years) with treated periodontitis were identified. Comparison was made between patients with mild form and severe form of treated periodontitis after propensity score matching. The primary end point was the incidence of MACE.

Results: A total of 32,504 adult patients with treated periodontitis were identified between 2001 and 2010. After propensity score matching, 27,146 patients were preserved for comparison, including 13,573 patients with mild form and 13,573 patients with severe form of treated periodontitis. During follow-up, 728 individuals in mild treated periodontitis group and 1,206 individuals in severe treated periodontitis group had at least 1 MACE event. After adjustment for gender, hyperlipidemia, hypertension and diabetes mellitus, severe treated periodontitis was associated with a mildly but significantly increased risk of MACE among older patients > 60 years of age (incidence rate ratio, 1.26; 95% confidence interval, 1.08-1.46). No association was found among younger patients ≤ 60 years of age.

Conclusions: Severe form of treated periodontitis was associated with an increased risk of MACE among older Taiwanese patients, but not among younger Taiwanese patients. We should put more efforts on the improvement of periodontal health to prevent further MACE.

No MeSH data available.


Related in: MedlinePlus

Selection of study subjects and identification of major adverse cardiovascular events (MACE) in treated periodontitis in Taiwan from 2001 to 2010.
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pone.0130807.g001: Selection of study subjects and identification of major adverse cardiovascular events (MACE) in treated periodontitis in Taiwan from 2001 to 2010.

Mentions: During 2001–2010, 32,504 adult patients (aged ≥ 18 years) with treated periodontitis were identified from the random sample of 1,000,000 insurants of the National Health Insurance program (a subset of the NHIRD). Younger patients (aged <18 years), the patients with a first MACE before periodontitis being diagnosed, and the patients without procedure information to confirm them were excluded (Fig 1). Diagnostic information was based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Diagnostic codes of periodontitis (ICD-9 5234 and 5235) and procedure codes (91006C, 91007C, 91008C, 91009B, 91010B, 92013C, and 92014C) were used. The procedure codes were grouped into I (91006C, 91007C or 91008C; subgingival curettage of full mouth, half arch or less than 3 teeth respectively), II (91009B, 91010B; periodontal flap operation of less than 3 teeth or 4 to 6 teeth respectively) and III (92013C, 92014C; simple extraction or complicated extraction respectively). Accordingly, mild form of treated periodontitis was defined by a diagnostic code and a procedure code of group I; severe form was defined by a diagnostic code and any combination of these procedure codes except solely group I or group III.


Major Adverse Cardiovascular Events in Treated Periodontitis: A Population-Based Follow-Up Study from Taiwan.

Chou SH, Tung YC, Lin YS, Wu LS, Lin CP, Liou EJ, Chang CJ, Kung S, Chu PH - PLoS ONE (2015)

Selection of study subjects and identification of major adverse cardiovascular events (MACE) in treated periodontitis in Taiwan from 2001 to 2010.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4482590&req=5

pone.0130807.g001: Selection of study subjects and identification of major adverse cardiovascular events (MACE) in treated periodontitis in Taiwan from 2001 to 2010.
Mentions: During 2001–2010, 32,504 adult patients (aged ≥ 18 years) with treated periodontitis were identified from the random sample of 1,000,000 insurants of the National Health Insurance program (a subset of the NHIRD). Younger patients (aged <18 years), the patients with a first MACE before periodontitis being diagnosed, and the patients without procedure information to confirm them were excluded (Fig 1). Diagnostic information was based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Diagnostic codes of periodontitis (ICD-9 5234 and 5235) and procedure codes (91006C, 91007C, 91008C, 91009B, 91010B, 92013C, and 92014C) were used. The procedure codes were grouped into I (91006C, 91007C or 91008C; subgingival curettage of full mouth, half arch or less than 3 teeth respectively), II (91009B, 91010B; periodontal flap operation of less than 3 teeth or 4 to 6 teeth respectively) and III (92013C, 92014C; simple extraction or complicated extraction respectively). Accordingly, mild form of treated periodontitis was defined by a diagnostic code and a procedure code of group I; severe form was defined by a diagnostic code and any combination of these procedure codes except solely group I or group III.

Bottom Line: After propensity score matching, 27,146 patients were preserved for comparison, including 13,573 patients with mild form and 13,573 patients with severe form of treated periodontitis.After adjustment for gender, hyperlipidemia, hypertension and diabetes mellitus, severe treated periodontitis was associated with a mildly but significantly increased risk of MACE among older patients > 60 years of age (incidence rate ratio, 1.26; 95% confidence interval, 1.08-1.46).No association was found among younger patients ≤ 60 years of age.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.

ABSTRACT

Background: The aim of the present study was to identify the long-term major adverse cardiovascular events (MACE) in treated periodontitis patients in Taiwan.

Methods: From the National Health Insurance Research Database (2001-2010), adult patients (≥ 18 years) with treated periodontitis were identified. Comparison was made between patients with mild form and severe form of treated periodontitis after propensity score matching. The primary end point was the incidence of MACE.

Results: A total of 32,504 adult patients with treated periodontitis were identified between 2001 and 2010. After propensity score matching, 27,146 patients were preserved for comparison, including 13,573 patients with mild form and 13,573 patients with severe form of treated periodontitis. During follow-up, 728 individuals in mild treated periodontitis group and 1,206 individuals in severe treated periodontitis group had at least 1 MACE event. After adjustment for gender, hyperlipidemia, hypertension and diabetes mellitus, severe treated periodontitis was associated with a mildly but significantly increased risk of MACE among older patients > 60 years of age (incidence rate ratio, 1.26; 95% confidence interval, 1.08-1.46). No association was found among younger patients ≤ 60 years of age.

Conclusions: Severe form of treated periodontitis was associated with an increased risk of MACE among older Taiwanese patients, but not among younger Taiwanese patients. We should put more efforts on the improvement of periodontal health to prevent further MACE.

No MeSH data available.


Related in: MedlinePlus