The role of periopathogens in pathogenenesis of atherosclerotic disease

Abstract

Introduction. The relationship between chronic inflammation processes, including periodontitis and pathogenesis
of atherosclerosis, has been studied for over twenty years. Therefore, the aim of this study was
an assessment of the occurrence of selected anaerobic bacteria: in atherosclerotic plaque in patients treated
surgically due to occlusion of coronary vessels, and in atherosclerotic plaque in patients treated surgically
due to haemodynamically significant internal carotid artery stenosis, with a high risk of cerebral stroke. The analysis also included periodontitis progression indices and their impact on the occurrence of periopathogens in the walls of diseased arteries.

Material and methods. The study included 40 patients: 20 individuals after aortocoronary bypass implant
and 20 individuals hospitalized due to haemodynamically significant internal carotid artery stenosis,
who underwent endarterectomy. Atherosclerotic plaque was assessed bacteriologically with PCR tests. The impact of periodontitis progression parameters on the occurrence of periopathogens in diseased arteries was
also evaluated.

Results. In 65% of patients in the cardiac group and in 20% of patients in the stroke group, periopathogens
were observed in atherosclerotic arteries. Patients with periopathogens indicated significantly increased
bleeding index and percentage of periodontal pockets ≥ 4 mm compared to patients without periopathogens
in atherosclerotic plaque.

Conclusions. Active inflammatory process in deep periodontal pockets is responsible for the transfer of periopathogens
from diseased periodontal tissues to remote arterial vessels.