Clarithromycin reduces recurrent cardiovascular events in subjects without periodontitis
Identifieur interne : 007073 ( Main/Exploration ); précédent : 007072; suivant : 007074Clarithromycin reduces recurrent cardiovascular events in subjects without periodontitis
Auteurs : Susanna Paju [Finlande] ; Pirkko J. Pussinen [Finlande] ; Juha Sinisalo [Finlande] ; Kimmo Mattila [Finlande] ; Basak Dogan [Finlande, Turquie] ; Jari Ahlberg [Finlande] ; Ville Valtonen [Finlande] ; Markku S. Nieminen [Finlande] ; Sirkka Asikainen [Suède]Source :
- Atherosclerosis [ 0021-9150 ] ; 2006.
Descripteurs français
- Pascal (Inist)
- Appareil circulatoire pathologie, Athérosclérose, Parodontite, Infarctus myocarde, Angor instable, Infection, Cardiopathie coronaire, Edentation, Clarithromycine, Homme, Inflammation, Onde Q, Etude double insu, Etude comparative, Lipopolyoside, IgG, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Séropositivité, Traitement, Prévention, Antibactérien, Antibiotique, Haemophilus actinomycetemcomitans.
- Wicri :
- topic : Homme, Antibiotique.
English descriptors
- KwdEn :
- Actinobacillus actinomycetemcomitans, Antibacterial agent, Antibiotic, Atherosclerosis, Cardiovascular disease, Clarithromycin, Comparative study, Coronary heart disease, Double blind study, Edentulousness, Human, IgG, Infection, Inflammation, Lipopolysaccharide, Myocardial infarction, Periodontitis, Porphyromonas gingivalis, Prevention, Q wave, Seropositivity, Treatment, Variant angina.
Abstract
Inflammation leading to acute coronary syndrome may be triggered by bacteria causing periodontal infection. We investigated if recurrence of cardiovascular events in unstable coronary patients are associated with periodontitis or microbiological/serological markers of it. Periodontitis-related parameters of 141 patients with acute non-Q-wave infarction or unstable angina pectoris, who participated in a double-blind, placebo-controlled study with clarithromycin for 3 months, were adjusted to the occurrence of a recurrent cardiovascular event during a follow-up period (average 519 days). In the age group under 65 years the patients with periodontitis had a univariate odds ratios (OR) 95% confidence intervals (95% CI) of 5.0 (1.02-24.55) for a recurrent cardiovascular event in comparison with patients without periodontitis. Dental status correlated positively with serum lipopolysaccharide concentrations and combined IgG antibody response to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. The end point frequency did not differ between clarithromycin and placebo groups in bacterium-positive, seropositive, or periodontitis patients. Fewer end points in clarithromycin group were seen in bacterium-negative, seronegative, edentulous, and non-periodontitis patients. Periodontitis and edentulousness are associated with recurrent cardiovascular events, especially in younger patients. Long-term clarithromycin therapy seems to be beneficial in prevention of recurrent cardiovascular events in non-periodontitis but not in periodontitis patients.
Affiliations:
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Pussinen</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital</s1><s2>Helsinki</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Helsinki</wicri:noRegion><orgName type="university">Université d'Helsinki</orgName><placeName><settlement type="city">Helsinki</settlement><region type="région" nuts="2">Uusimaa</region></placeName></affiliation></author><author><name sortKey="Sinisalo, Juha" sort="Sinisalo, Juha" uniqKey="Sinisalo J" first="Juha" last="Sinisalo">Juha Sinisalo</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Medicine, Division of Cardiology, Helsinki University Central Hospital</s1><s2>Helsinki</s2><s3>FIN</s3><sZ>3 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Mattila, Kimmo" sort="Mattila, Kimmo" uniqKey="Mattila K" first="Kimmo" last="Mattila">Kimmo Mattila</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Medicine, Division of Infectious Diseases, Helsinki University Central Hospital</s1><s2>Helsinki</s2><s3>FIN</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Dogan, Basak" sort="Dogan, Basak" uniqKey="Dogan B" first="Basak" last="Dogan">Basak Dogan</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital</s1><s2>Helsinki</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Helsinki</wicri:noRegion><orgName type="university">Université d'Helsinki</orgName><placeName><settlement type="city">Helsinki</settlement><region type="région" nuts="2">Uusimaa</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Basic Sciences, Faculty of Health Education, Marmara University</s1><s2>Istanbul</s2><s3>TUR</s3><sZ>5 aut.</sZ></inist:fA14><country>Turquie</country><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Ahlberg, Jari" sort="Ahlberg, Jari" uniqKey="Ahlberg J" first="Jari" last="Ahlberg">Jari Ahlberg</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital</s1><s2>Helsinki</s2><s3>FIN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Helsinki</wicri:noRegion><orgName type="university">Université d'Helsinki</orgName><placeName><settlement type="city">Helsinki</settlement><region type="région" nuts="2">Uusimaa</region></placeName></affiliation></author><author><name sortKey="Valtonen, Ville" sort="Valtonen, Ville" uniqKey="Valtonen V" first="Ville" last="Valtonen">Ville Valtonen</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Medicine, Division of Infectious Diseases, Helsinki University Central Hospital</s1><s2>Helsinki</s2><s3>FIN</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Nieminen, Markku S" sort="Nieminen, Markku S" uniqKey="Nieminen M" first="Markku S." last="Nieminen">Markku S. Nieminen</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Medicine, Division of Cardiology, Helsinki University Central Hospital</s1><s2>Helsinki</s2><s3>FIN</s3><sZ>3 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Helsinki</wicri:noRegion></affiliation></author><author><name sortKey="Asikainen, Sirkka" sort="Asikainen, Sirkka" uniqKey="Asikainen S" first="Sirkka" last="Asikainen">Sirkka Asikainen</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Institute of Odontology, Division of Oral Microbiology, Umeå University, Tandlakarhogskolan</s1><s2>90187 Umeå</s2><s3>SWE</s3><sZ>9 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>90187 Umeå</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Atherosclerosis</title><title level="j" type="abbreviated">Atherosclerosis</title><idno type="ISSN">0021-9150</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Atherosclerosis</title><title level="j" type="abbreviated">Atherosclerosis</title><idno type="ISSN">0021-9150</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Actinobacillus actinomycetemcomitans</term><term>Antibacterial agent</term><term>Antibiotic</term><term>Atherosclerosis</term><term>Cardiovascular disease</term><term>Clarithromycin</term><term>Comparative study</term><term>Coronary heart disease</term><term>Double blind study</term><term>Edentulousness</term><term>Human</term><term>IgG</term><term>Infection</term><term>Inflammation</term><term>Lipopolysaccharide</term><term>Myocardial infarction</term><term>Periodontitis</term><term>Porphyromonas gingivalis</term><term>Prevention</term><term>Q wave</term><term>Seropositivity</term><term>Treatment</term><term>Variant angina</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Appareil circulatoire pathologie</term><term>Athérosclérose</term><term>Parodontite</term><term>Infarctus myocarde</term><term>Angor instable</term><term>Infection</term><term>Cardiopathie coronaire</term><term>Edentation</term><term>Clarithromycine</term><term>Homme</term><term>Inflammation</term><term>Onde Q</term><term>Etude double insu</term><term>Etude comparative</term><term>Lipopolyoside</term><term>IgG</term><term>Actinobacillus actinomycetemcomitans</term><term>Porphyromonas gingivalis</term><term>Séropositivité</term><term>Traitement</term><term>Prévention</term><term>Antibactérien</term><term>Antibiotique</term><term>Haemophilus actinomycetemcomitans</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Antibiotique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Inflammation leading to acute coronary syndrome may be triggered by bacteria causing periodontal infection. We investigated if recurrence of cardiovascular events in unstable coronary patients are associated with periodontitis or microbiological/serological markers of it. Periodontitis-related parameters of 141 patients with acute non-Q-wave infarction or unstable angina pectoris, who participated in a double-blind, placebo-controlled study with clarithromycin for 3 months, were adjusted to the occurrence of a recurrent cardiovascular event during a follow-up period (average 519 days). In the age group under 65 years the patients with periodontitis had a univariate odds ratios (OR) 95% confidence intervals (95% CI) of 5.0 (1.02-24.55) for a recurrent cardiovascular event in comparison with patients without periodontitis. Dental status correlated positively with serum lipopolysaccharide concentrations and combined IgG antibody response to Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. The end point frequency did not differ between clarithromycin and placebo groups in bacterium-positive, seropositive, or periodontitis patients. Fewer end points in clarithromycin group were seen in bacterium-negative, seronegative, edentulous, and non-periodontitis patients. Periodontitis and edentulousness are associated with recurrent cardiovascular events, especially in younger patients. Long-term clarithromycin therapy seems to be beneficial in prevention of recurrent cardiovascular events in non-periodontitis but not in periodontitis patients.</div></front></TEI><affiliations><list><country><li>Finlande</li><li>Suède</li><li>Turquie</li></country><region><li>Uusimaa</li></region><settlement><li>Helsinki</li></settlement><orgName><li>Université d'Helsinki</li></orgName></list><tree><country name="Finlande"><region name="Uusimaa"><name sortKey="Paju, Susanna" sort="Paju, Susanna" uniqKey="Paju S" first="Susanna" last="Paju">Susanna Paju</name></region><name sortKey="Ahlberg, Jari" sort="Ahlberg, Jari" uniqKey="Ahlberg J" first="Jari" last="Ahlberg">Jari Ahlberg</name><name sortKey="Dogan, Basak" sort="Dogan, Basak" uniqKey="Dogan B" first="Basak" last="Dogan">Basak Dogan</name><name sortKey="Mattila, Kimmo" sort="Mattila, Kimmo" uniqKey="Mattila K" first="Kimmo" last="Mattila">Kimmo Mattila</name><name sortKey="Nieminen, Markku S" sort="Nieminen, Markku S" uniqKey="Nieminen M" first="Markku S." last="Nieminen">Markku S. Nieminen</name><name sortKey="Pussinen, Pirkko J" sort="Pussinen, Pirkko J" uniqKey="Pussinen P" first="Pirkko J." last="Pussinen">Pirkko J. Pussinen</name><name sortKey="Sinisalo, Juha" sort="Sinisalo, Juha" uniqKey="Sinisalo J" first="Juha" last="Sinisalo">Juha Sinisalo</name><name sortKey="Valtonen, Ville" sort="Valtonen, Ville" uniqKey="Valtonen V" first="Ville" last="Valtonen">Ville Valtonen</name></country><country name="Turquie"><noRegion><name sortKey="Dogan, Basak" sort="Dogan, Basak" uniqKey="Dogan B" first="Basak" last="Dogan">Basak Dogan</name></noRegion></country><country name="Suède"><noRegion><name sortKey="Asikainen, Sirkka" sort="Asikainen, Sirkka" uniqKey="Asikainen S" first="Sirkka" last="Asikainen">Sirkka Asikainen</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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