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Number of teeth, C‐reactive protein, fibrinogen and cardiovascular mortality: a 15‐year follow‐up study in a Finnish cohort
Author(s) -
Janket SokJa,
Baird Alison E.,
Jones Judith A.,
Jackson Elizabeth A.,
Surakka Markku,
Tao Wen,
Meurman Jukka H.,
Dyke Thomas E.
Publication year - 2014
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.12192
Subject(s) - medicine , proportional hazards model , fibrinogen , hazard ratio , cohort , coronary artery disease , cohort study , c reactive protein , dentistry , gastroenterology , inflammation , confidence interval
Aim To test whether the number of teeth, an inverse proxy for composite oral infection scores is associated with better survival. Materials and Methods The Kuopio Oral Health and Heart study initiated a case–control study in 1995–1996 consisting of 256 consecutive coronary artery disease patients and 250 age and gender‐matched controls. We appended the mortality data and formulated a longitudinal study. By May 31st, 2011, 124 mortalities had occurred and 80 of which were of cardiovascular origin. Using Cox proportional hazards models, we assessed the association of the teeth group (Teethgrp) – consisting of 10 teeth – with cardiovascular and all‐cause mortality after 15.8 years of median follow‐up. Results In multivariate models, with the edentulous state as reference, one level increase in Teethgrp was associated with significantly increased survival from cardiovascular disease (CVD) mortality with a Hazard Ratio (HR) 0.73, p ‐value = 0.02 but not with all‐cause mortality (HR = 0.87, p = 0.13). The findings were not mediated by C‐reactive protein (CRP) levels ≥3 mg/L or by median fibrinogen levels, but were mediated by CRP levels >5 mg/L. Conclusion Each increment of 10 teeth from the edentulous state was associated with a 27% improved CVD survival, independent of low‐grade systemic inflammation.