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Associations between self-reported periodontal disease, assessed using a very short questionnaire, cardiovascular disease events and all-cause mortality in a contemporary multi-ethnic population: The Multi-Ethnic Study of Atherosclerosis (MESA).
- Source :
-
Atherosclerosis [Atherosclerosis] 2018 Nov; Vol. 278, pp. 110-116. Date of Electronic Publication: 2018 Sep 20. - Publication Year :
- 2018
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Abstract
- Background and Aims: Periodontal disease (PD) is believed to be associated with cardiovascular disease (CVD) events. Nevertheless, the additive prognostic value of PD for the prediction of CVD events beyond traditional risk factors is unclear, particularly when self-reported using a short questionnaire.<br />Methods: In the community-based, multicenter, prospective, Multi-Ethnic Study of Atherosclerosis (MESA), PD was assessed at baseline using a two-item questionnaire. We used Cox proportional hazards regression models to evaluate the independent associations between self-reported PD and coronary heart disease (CHD), CVD events, and all-cause death. In addition, the area under the receiver-operator characteristic curve (AUC) was calculated for each of the study endpoints, for models including traditional CVD risk factors alone and models including traditional CVD risk factors plus information on PD. Subgroup analyses were performed stratifying by age and tobacco use.<br />Results: Among the 6640 MESA participants, high education level, high income, and access to healthcare were more frequent among individuals who self-reported PD. In multivariable analyses, null associations were observed between self-reported PD and incident CVD events, CHD events, and all-cause mortality; and self-reported PD did not improve risk prediction beyond traditional CVD risk factors in terms of AUC, for any of the three study endpoints. Subgroup analyses were consistent with the overall results.<br />Conclusions: Our findings suggest that the prevalence of self-reported PD may be strongly influenced by educational status and other socioeconomic features. In this context, self-reported PD does not improve CVD risk assessment when evaluated using a brief questionnaire. Future studies should prioritize objective, dental health-expert assessments of PD.<br /> (Copyright © 2018. Published by Elsevier B.V.)
- Subjects :
- Aged
Aged, 80 and over
Area Under Curve
Atherosclerosis complications
Atherosclerosis diagnosis
Atherosclerosis ethnology
Coronary Disease complications
Coronary Disease diagnosis
Coronary Disease ethnology
Educational Status
Ethnicity
Female
Humans
Male
Middle Aged
Mortality
Multivariate Analysis
Periodontal Diseases complications
Periodontal Diseases diagnosis
Periodontal Diseases ethnology
Prognosis
Proportional Hazards Models
Prospective Studies
Risk Factors
Self Report
Sensitivity and Specificity
Social Class
Surveys and Questionnaires
Atherosclerosis epidemiology
Coronary Disease epidemiology
Periodontal Diseases epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1484
- Volume :
- 278
- Database :
- MEDLINE
- Journal :
- Atherosclerosis
- Publication Type :
- Academic Journal
- Accession number :
- 30265891
- Full Text :
- https://doi.org/10.1016/j.atherosclerosis.2018.09.026