TY - JOUR
T1 - Periodontal Disease, Atrial Fibrillation and Stroke
AU - Sen, Souvik
AU - Redd, Kolby
AU - Trivedi, Tushar
AU - Moss, Kevin
AU - Alonso, Alvaro
AU - Soliman, Elsayed Z.
AU - Magnani, Jared W.
AU - Chen, Lin Y.
AU - Gottesman, Rebecca F.
AU - Rosamond, Wayne
AU - Beck, James
AU - Offenbacher, Stephen
N1 - Funding Information:
Alvaro Alonso was supported by American Heart Association grant 16EIA26410001.
Funding Information:
The ARIC study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services , under Contract nos. ( HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I ). The authors thank the staff and participants of the ARIC study for their important contributions.
Funding Information:
Souvik Sen MD is the PI on 1 R01 MD009738 PeRiodontal treatment to Eliminate Minority InEquality and Rural disparities in Stroke (PREMIERS) supported by National Institute of Minority Health Disparity .
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/5
Y1 - 2021/5
N2 - Background: We recently described the association between periodontal disease (PD) and stroke risk. Purpose: The purpose of this study was to test the association between PD, dental care utilization and incident atrial fibrillation (AF), as well as AF as a mediator to PD- stroke association. Methods: In dental cohort of the Atherosclerosis Risk in Communities Study (ARIC), participants without prior AF underwent full-mouth periodontal measurements. PD was defined on an ordinal scale as healthy (referent), mild, moderate and severe. In ARIC main cohort, participants were classified as regular or episodic dental care users. These patients were followed for AF, over 17 years. Cox proportional hazards models adjusted for AF risk factors were used to study relationships between PD severity, dental care utilization and AF. Mediation analysis was used to test if AF mediated the PD- stroke association. Results: In dental ARIC cohort, 5,958 were assessed without prior AF, 754 were found to have AF. Severe PD was associated with AF on both univariable (crude HR, 1.54; 95% CI, 1.26-1.87) and multivariable (adjusted HR, 1.31, 95% CI, 1.06-1.62) analyses. Mediation analysis suggested AF mediates the association between PD and stroke. In the main ARIC cohort, 9,666 participants without prior AF were assessed for dental care use, 1558 were found to have AF. Compared with episodic users, regular users had a lower risk for AF on univariable (crude HR, 0.82, 95% CI, 0.74-0.90) and multivariable (adjusted HR, 0.88, 95% CI, 0.78-0.99) analyses. Conclusions: PD is associated with AF. The association may explain the PD-stroke risk. Regular users had a lower risk of incident AF compared with episodic users.
AB - Background: We recently described the association between periodontal disease (PD) and stroke risk. Purpose: The purpose of this study was to test the association between PD, dental care utilization and incident atrial fibrillation (AF), as well as AF as a mediator to PD- stroke association. Methods: In dental cohort of the Atherosclerosis Risk in Communities Study (ARIC), participants without prior AF underwent full-mouth periodontal measurements. PD was defined on an ordinal scale as healthy (referent), mild, moderate and severe. In ARIC main cohort, participants were classified as regular or episodic dental care users. These patients were followed for AF, over 17 years. Cox proportional hazards models adjusted for AF risk factors were used to study relationships between PD severity, dental care utilization and AF. Mediation analysis was used to test if AF mediated the PD- stroke association. Results: In dental ARIC cohort, 5,958 were assessed without prior AF, 754 were found to have AF. Severe PD was associated with AF on both univariable (crude HR, 1.54; 95% CI, 1.26-1.87) and multivariable (adjusted HR, 1.31, 95% CI, 1.06-1.62) analyses. Mediation analysis suggested AF mediates the association between PD and stroke. In the main ARIC cohort, 9,666 participants without prior AF were assessed for dental care use, 1558 were found to have AF. Compared with episodic users, regular users had a lower risk for AF on univariable (crude HR, 0.82, 95% CI, 0.74-0.90) and multivariable (adjusted HR, 0.88, 95% CI, 0.78-0.99) analyses. Conclusions: PD is associated with AF. The association may explain the PD-stroke risk. Regular users had a lower risk of incident AF compared with episodic users.
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U2 - 10.1016/j.ahj.2021.01.009
DO - 10.1016/j.ahj.2021.01.009
M3 - Article
C2 - 33503409
AN - SCOPUS:85100902697
SN - 0002-8703
VL - 235
SP - 36
EP - 43
JO - American heart journal
JF - American heart journal
ER -