Clinical trial NCT01045070: Periodontitis and Coronary Heart Disease
Official title: Periodontitis and Its Microbiological Agents as Prognostic Factors in Patients With Coronary Heart Disease
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Periodontitis
Coronary Heart Disease
Keywords: periodontitis and coronary heart disease
Lead sponsor: Martin-Luther-Universität Halle-Wittenberg
Sponsor class: OTHER
Collaborators: name: The German Heart Foundation
First posted: 2010-01-08
Enrollment: 960
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients with coronary heart disease, admitted to the Martin Luther-University Halle-Wittenberg

Brief summary: "Atherosclerosis is an inflammatory disease". The hypothesis of an infectious burden as trigger or initiator of the inflammatory process in atherosclerosis has been extensively discussed in the past years. One part of this discussion is focused on the infectious agents responsible for periodontitis. Several studies have found an association of periodontitis and/or bacteria related to this disease and atherosclerosis. However, a study focussing on the prognostic relevance of these factors is missing.

The hypothesis of this study is that periodontitis is a prognostic relevant risk factor for patients with angiographically proven coronary heart disease. Furthermore, the infectious pathogen burden by PCR-detection of periodontal pathogens will be evaluated as a prognostic factor.

960 consecutive patients with angiographically proven coronary heart disease will be included in this study. After inclusion of patients an extensive periodontal examination including PCR-sampling for 11 bacteria (Porphyromonas gingivitis, Actinobacillus actinomycetemcomitans, and others) will be performed. After 12 months patient will be follow up for any major adverse events (cardiovascular death, myocardial infarction, stroke).

If this study will find a relation of periodontitis or its microbiological agents to cardiovascular outcome of patients with coronary heart disease, further studies are necessary to investigate potential therapeutic consequences for patients with CHD and periodontitis.


Eligibility criteria: Inclusion Criteria:

* Age \>18 years
* Coronary heart disease as defined by previous or current detection of 50% stenosis of a main coronary artery by coronary angiography or previous or current percutaneous coronary intervention (PCI) or previous or current coronary artery bypass surgery (CABG)

Exclusion Criteria:

* Inability to give written informed consent
* Periodontal treatment and/or antibiotic therapy during the last 6 months
* Pregnancy
* Current alcohol or drug abuse, or psychological reasons that make study participation impractical
* Drugs which are potential causal for gingival hyperplasia (Hydantoin, Nifedipine, Cyclosporin A, and other)

Primary outcomes:
measure: Combined endpoint: myocardial infarction, cardiovascular death, stroke
timeFrame: 12 months follow-up
Secondary outcomes:
Other outcomes:
Locations:
city: Halle (Saale)
country: Germany
facility: Martin Luther-University Halle-Wittenberg
Study officials:
affiliation: Department of Medicine III, Martin Luther-University Halle-Wittenberg
name: Axel Schlitt, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Schulz S, Zielske M, Schneider S, Hofmann B, Schaller HG, Schlitt A, Reichert S. Polymorphism of CD14 Gene Is Associated with Adverse Outcome among Patients Suffering from Cardiovascular Disease. Mediators Inflamm. 2021 Jul 8;2021:3002439. doi: 10.1155/2021/3002439. eCollection 2021.
citation: Reichert S, Seitter L, Schaller HG, Schlitt A, Schulz S. ANRIL polymorphisms (rs1333049 and rs3217992) in relation to plasma CRP levels among in-patients with CHD. Cytokine. 2020 Mar;127:154932. doi: 10.1016/j.cyto.2019.154932. Epub 2019 Nov 27.
citation: Schulz S, Schlitt A, Hofmann B, Schaller HG, Reichert S. Periodontal pathogens and their role in cardiovascular outcome. J Clin Periodontol. 2020 Feb;47(2):173-181. doi: 10.1111/jcpe.13224. Epub 2019 Dec 16.
citation: Reichert S, Schlitt A, Benten AC, Hofmann B, Schaller HG, Schulz S. Data on IL-6 c.-174 G>C genotype and allele frequencies in patients with coronary heart disease in dependence of cardiovascular outcome. Data Brief. 2016 Jul 16;8:1295-9. doi: 10.1016/j.dib.2016.07.020. eCollection 2016 Sep.
citation: Schulz S, Schlitt A, Lutze A, Lischewski S, Seifert T, Dudakliewa T, Gawe R, Werdan K, Hofmann B, Glaser C, Schaller HG, Reichert S. The importance of genetic variants in TNFalpha for periodontal disease in a cohort of coronary patients. J Clin Periodontol. 2012 Aug;39(8):699-706. doi: 10.1111/j.1600-051X.2012.01909.x. Epub 2012 Jun 12.