Periodontal disease in association with Myocardial Infarction with Non-Obstructive Coronary Arteries and Microvascular Coronary Artery Disease

OBJECTIVE. We sought to evaluate any association of periodontitis in patients with angina despite non-obstructive coronary artery disease (CAD). METHODS. Electronic records of all patients (n=103,955) labeled as ACS were screened and the patients diagnosed with myocardial infarction with non-obstructive coronary arteries (MINOCA) were enrolled as group 1 and age-matched controls with no CAD were labeled as group 2. RESULTS. Female gender (OR (95%CI): 1.04 (0.93 – 1.59); p=0.004), diabetes mellitus (OR (95%CI): 0.25 (0.05– 0.63); p=0.02), peripheral arterial disease (OR (95%CI): 0.78 (0.63 – 0.91); p=0.001), dyslipidemia (OR (95%CI): 1.45 (0.47 – 2.93); p=0.015), smoking, moderate (OR (95%CI): 5.42 (1.91 – 22.69); p=0.04) and severe periodontitis (OR (95%CI): 2.58 (1.72 – 3.26); p=0.027) were independent predictors of MINOCA. There was an increased graded risk (relative risk (RR)) of MINOCA with periodontitis + diabetes mellitus (RR (95%CI): 0.91 (0.34 – 1.23); p=0.032), periodontitis + peripheral arterial disease (RR (95%CI): 0.85 (0.47 – 1.46); p=0.025), periodontitis + renal disease (RR (95%CI): 1.04 (0.85 – 1.23); p=0.04), and periodontitis + smoking (RR (95%CI): 0.94 (0.77 – 1.06); p=0.006). CONCLUSION. This study demonstrated that moderate to severe periodontitis might be independently associated with the increased incidence of MINOCA among the general population. Furthermore, it discovered various predictors of MINOCA among the general population.