Link between periodontitis and cardiovascular disease in ind
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Both periodontal disease and cardiovascular disease (CVD) are over-represented in rheumatoid arthritis (RA). However, the contribution of periodontal pathogens to CVD in RA is unknown.

RA patients underwent assessments of coronary artery calcification (CAC), carotid intima media thickness and plaque, and ankle-brachial index via computed tomography, ultrasound, and Doppler ultrasound, respectively. Sera were assayed for antibodies targeting Porphyromonas gingivalis (anti-Pg), Aggregatibacter actinomycetemcomitans serotype b (anti-Aa), and Aa leukotoxin A (anti-LtxA). Associations of antibodies against these periodontal pathogens with measures of atherosclerosis were explored using generalized linear models.

Results:
-- Among 197 RA patients, anti-Pg was detected in 72 (37%), anti-Aa in 41 (21%), and anti-LtxA in 84 (43%).

-- Adjusting for relevant confounders and reported tooth loss, the mean CAC score was 90% higher in those with anti-Aa and/or anti-LtxA vs. those without either antibody.

-- The adjusted odds of CAC greater than 100 units was 2.23-fold higher for those with anti-Aa and/or anti-LtxA vs. those without either antibody.

-- Anti-Aa and/or anti-LtxA seropositivity was associated significantly with all other assessed measures of atherosclerosis except carotid plaque.

-- Anti-Pg was not associated with any measure of atherosclerosis.

-- Higher swollen joint count was associated with CAC exclusively in the group with anti-Aa and/or anti-LtxA.

Conclusively, Immunoreactivity against Aa and/or its major virulence factor LtxA was associated with atherosclerosis in multiple vascular beds of RA patients, and amplified the effect of swollen joints on coronary atherosclerosis, suggesting a role for treatment/prevention of periodontal disease in the prevention of CVD in RA.

Source: https://onlinelibrary.wiley.com/doi/10.1002/art.41572
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