Association of Periodontitis, elevated c reactive protein levels and acute myocardial infarction – A case control study

Background & Objectives: Destructive periodontal diseases (PD) have been associated with increased risk of atherosclerotic complications, including acute myocardial infarction (AMI) and stroke. The ability of Periodontitis to produce systemic C-reactive protein (CRP) level elevations may represent the link with cardiovascular events. Hence, the aim of this study was to compare the serum levels of CRP in AMI patients (with and without periodontitis) and a control group. This study also explored the possibility of using CRP levels in patients with periodontitis as a possible risk marker and a screening tool for predicting future cardiovascular disease independent of the conventional risk factors. Methodology: 40 cases of AMI were taken as cases and 40 age and sex matched healthy individuals were taken as controls. Community Periodontal Index (CPI) score and Loss of Attachment (LOA) score were determined, as well as CRP level estimated from blood for every individual examined. Results: It was noted that CRP levels were higher in the individuals with PD both in cases and controls. CRP levels in the AMI patients with PD were much higher than the CRP levels in healthy individuals with a positive correlation of CPI, LOA and CRP. A cut off value for CRP level was determined using the ROC curve and noted that values above 0.45mg/L are at a higher risk. Conclusion: The assessment of CRP levels in the individuals with PD would therefore work as a screening tool and help us in educating the patient about the adverse effects of periodontal ill health.