CardioExchange Archive

A new study adds to the evidence linking periodontal disease to cardiovascular events, suggesting a common basis in acute inflammation. In a report in the Annals of Internal Medicine, Caroline Minassian and colleagues analyzed a Medicaid database of 1175 patients discharged with ischemic stroke or MI who had received invasive dental treatment. They observed a small but significant increase in CV risk the first 4 weeks after the dental procedure, with a gradual return to the baseline risk within 6 months. The authors write that their findings “lend support to the hypothesis that inflammation may play an important role in the occurrence of vascular events,” but they also point out that other factors may play a role, since people who undergo dental procedures may stop taking aspirin prior to the procedure and may receive NSAIDs after the procedure.

In an accompanying editorial, Howard Weitz and Geno Merli note that despite recommendations that aspirin should not be discontinued prior to a dental procedure, “our personal experience is that dental practitioners frequently request patients to withhold aspirin before periodontal therapy and dental extraction.” They cite a study in Ireland that found that 90% of practitioners stopped antiplatelet therapy prior to an extraction. The Annals study, they write, should serve as “an important reminder to continue cardioprotective antiplatelet agents if at all possible before and after dental procedures in patients who are receiving these agents. That is something that we can really sink our teeth into.”