Efectos del tratamiento periodontal sobre los marcadores de inflamación sistémica en pacientes con riesgo de enfermedad cardiaca coronaria. Estudio piloto

Background: Studies investigating effects of periodontal treatment (PT) on markers of inflammation in healthy subjects show conflicting results. Few studies have investigated the effects of PT among subjects with coronary heart disease (CHD) risk factors. Aim: To report the results of a pilot prospective study on the effects of periodontal treatment on markers of inflammation among subjects with CHD risk factors. Material and methods: Seventy three patients aged 53±6 years (25% males) with chronic periodontitis, dyslipidemia and other CHD risk factors were subjected to PT consisting on root planning and oral metronidazol and amoxicillin for 7 days. Periodontal clinical parameters, serum C-reactive protein (CRP), fibriNogen levels and erythrocyte sedimentation rate (ESR) were assessed before and at 6 weeks after PT. Polymorphisms at the IL1A-889 and IL1B+3954 genes were also geNotyped. Results: After the treatment period, CRP levels significantly increased from 3.6±3.7 mg/ L to 5.4±5.7 mg/L (p =0.001). No significant changes were observed in fibriNogen levels and ESR. Higher post-treatment CRP levels were significantly associated with the composite polymorphic geNotype at the IL1A-889 and IL1B+3954 genes (p =0.0001), and extensive periodontitis (p =0.005). Moderate alcohol consumption appeared as a protective factor for CRP elevation (p =0.029). Conclusions: The increase of the CRP levels after PT in patients with CVD risk factors appeared associated with IL-1 gene polymorphisms and extensive periodontitis.