Abstract 4138953: Salivary Tumor Necrosis Factor-Alpha, Plasma Omega-3 Fatty Acid Index and Coronary Artery Plaque

Background: Oral inflammation is thought to affect systemic atherosclerosis, but the mechanisms are unclear. Tumor necrosis factor-alpha (TNF-α) is an inflammatory cytokine that has been implicated in coronary plaque rupture as well as periodontitis by mediating periodontal destruction and inflammation. Blood levels of the omega-3 fatty acids have been inversely associated with systemic inflammation and coronary plaque volume, but their impact on oral inflammation requires further study. Objective: To examine the relationship between salivary levels of TNF-α, plasma levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and coronary plaque. Methods: Salivary TNF-α was measured in gingival crevicular fluid in 199 patients with clinical coronary artery disease on statin therapy. Fatty, fibrous and noncalcified coronary plaque volumes were measured using coronary CT angiography. The plasma omega-3 fatty acid index was the sum of EPA and DHA of total plasma fatty acids. Linear regression estimated the association between TNF-α, omega-3 fatty acid index and coronary plaque volumes. Results: Mean age was 62.7±7.5 years; mean LDL-C was 78.2±28.9 mg/dL, and median triglyceride was 119 [80.5,165.0] mg/dL. Higher salivary TNF-α was independently associated with a lower plasma omega-3 fatty acid index (Table 1). Moreover, higher salivary TNF-α was independently associated with higher fatty, fibrous, and noncalcified plaque volumes after adjustment for age, sex, BMI, triglyceride, LDL-C, diabetes status, diastolic blood pressure, albumin-to-creatinine ratio, and estimated glomerular filtration rate (Table 2). Conclusions: The inverse relationship between salivary TNF-α and the plasma omega-3 fatty acid index and direct relationship with fatty plaque suggests that maintaining high blood levels of omega-3 fatty acids may be beneficial in lowering oral inflammation and amount of fatty plaque, thus, potentially decreasing risk for acute coronary syndromes.