Association of periodontal disease with 12-month cardiovascular outcomes after acute myocardial infarction: A prospective cohort study

Objectives: While periodontal disease (PD) is epidemiologically linked to acute myocardial infarction (AMI), its prognostic significance for subsequent major adverse cardiovascular events (MACE) remains ill-defined. This study investigated whether pre-existing periodontal disease is associated with 12-month major adverse cardiovascular events after acute myocardial infarction. Methods: This prospective cohort study enrolled first-time AMI patients undergoing emergency percutaneous coronary intervention between January and September 2024, excluding those with severe comorbidities or edentulism. Participants were stratified by pre-admission PD status into AMI (n = 138) and PD + AMI (n = 154) cohorts. The primary endpoint was 12-month MACE, encompassing recurrent MI, in-stent restenosis, heart failure-related re-hospitalization, or cardiovascular mortality. The association between PD and MACE was evaluated using multivariate Cox proportional hazards regression, adjusted for traditional cardiovascular risk factors (age, sex, smoking, hypertension, diabetes, and low-density lipoprotein cholesterol). Results: Baseline assessments revealed that the PD + AMI cohort exhibited elevated triglyceride levels ( P = 0.038) and a higher prevalence of multivessel coronary lesions ( P = 0.031) compared to AMI controls. Over the 12-month follow-up, patients with PD experienced significantly higher rates of recurrent MI/in-stent restenosis (6.49% vs. 4.35%, P = 0.034), cardiovascular mortality (5.19% vs. 3.62%, P = 0.039), and overall MACE (26.62% vs. 21.01%, P = 0.037). Heart failure re-hospitalization rates were comparable between groups ( P = 0.642). Crucially, multivariate Cox regression identified pre-existing PD as an independent predictor of 12-month MACE (hazard ratio [HR] = 2.218, 95% CI: 1.243-3.956, P = 0.007). Conclusion: Periodontal disease was independently associated with higher 12-month adverse cardiovascular outcomes after acute myocardial infarction, suggesting that periodontal status may be considered as one of the factors in further risk assessment.