Skip to main content Skip to main navigation menu Skip to site footer

Role of cardiac marker troponin I in chronic periodontitis with coronary artery disease

  • Sanggap Indra Sitompul ,
  • Aryati ,
  • Budi Susetyo Pikir ,
  • Monika Estherlita Sinta ,

Abstract

Link of Video Abstract: https://youtu.be/Cw5keIvNHoQ

 

Introduction:  This study aims to analyze the effect of chronic periodontitis (CP) on  Troponin I levels in coronary artery disease (CAD) patients.

Patients and methods: This study was a cross-sectional study. A total of 90 CAD patients at Dr. Doris Sylvanus Hospital, Palangka Raya, Central Kalimantan, Indonesia, who underwent coronary angiography and had CP, was involved in the study. CAD was examined based on significant stenosis on coronary angiography. CP was measured based on mean physical diagnostic (PD) and panoramic X-rays. The blood sample was collected to determine Troponin I level by sandwich immunodetection method with fluorescence immunoassay (FIA). Bivariate analysis of factors affecting Troponin I (with threshold ROC results) was conducted using the Chi-square test, followed by multivariate analysis. A logistic regression test was also evaluated to determine the most influential independent variable on Troponin I.

Results: Based on bivariate analysis, CP and dyslipidemia significantly differed in both troponin groups. There was 53.3% mild CP at Troponin I level <0.015 ng/mL, while 80% moderate-severe CP at Troponin I level >0.015 ng/mL with p value=0.018. Based on multivariate analysis showed that CP had a significant effect on Troponin I. Additionally, patients with moderate-severe CP tended to have more Troponin I > 0.015 ng/mL with an odds ratio (OR) of 5.528 (95% CI 1.373-22.247; p value=0.016).

Conclusion: There was an effect of CP on increasing Troponin I levels in CAD patients.

References

  1. Kwon T, Lamster IB, Levin L. Current Concepts in the Management of Periodontitis. Int Dent J. 2021/02/19. 2021;71(6):462–76. Available from: https://pubmed.ncbi.nlm.nih.gov/34839889
  2. Panagakos F, Scannapieco F. Periodontal Inflammation: From Gingivitis to Systemic Disease? [Internet]. Gingival Diseases - Their Aetiology, Prevention and Treatment. InTech; 2011. Available from: http://dx.doi.org/10.5772/37923
  3. Asymal A, Astuti ER, Devijanti R. Changes in the number of macrophage and lymphocyte cells in chronic periodontitis due to dental X-ray exposure. Dent J. 2018;51(2):99–103. Available from: http://dx.doi.org/10.20473/j.djmkg.v51.i2.p99-103
  4. Boudoulas KD, Triposkiadis F, Geleris P, Boudoulas H. Coronary Atherosclerosis: Pathophysiologic Basis for Diagnosis and Management. Prog Cardiovasc Dis. 2016;58(6):676–92. Available from: http://dx.doi.org/10.1016/j.pcad.2016.04.003
  5. Sudjana PA, Achmad C, Yahya AF, Martha JW, Akbar MR. Correlation between Triglyceride/HDL Ratio with Severity of Coronary Artery Lesion in Non-Diabetic Stable Angina Pectoris Patients. ACI (Acta Cardiol Indones. 2018;4(2):95. Available from: http://dx.doi.org/10.22146/aci.40854
  6. Corcoran D, Ford TJ, Berry C. Stable Coronary Syndromes [Internet]. Textbook of Vascular Medicine. Springer International Publishing; 2019. p. 373–81. Available from: http://dx.doi.org/10.1007/978-3-030-16481-2_35
  7. Libby P. Inflammation in atherosclerosis. Nature. 2002;420(6917):868–74. Available from: http://dx.doi.org/10.1038/nature01323
  8. Scanlon PJ, Faxon DP, Audet A-M, Carabello B, Dehmer GJ, Eagle KA, et al. ACC/AHA Guidelines for Coronary Angiography: Executive Summary and Recommendations. Circulation. 1999;99(17):2345–57. Available from: http://dx.doi.org/10.1161/01.cir.99.17.2345
  9. Prahasanti C, Utomo H, Wijaksana IK. Porphyromonas gingivalis in Periodontitis: A Forgotten Enemy Behind COVID-19 Pandemic. Dent Hypotheses. 2021;12(1):28. Available from: http://dx.doi.org/10.4103/denthyp.denthyp_95_20
  10. Herrera D, Molina A, Buhlin K, Klinge B. Periodontal diseases and association with atherosclerotic disease. Periodontol 2000. 2020;83(1):66–89. Available from: http://dx.doi.org/10.1111/prd.12302
  11. Zhou M, Dong J, Zha L, Liao Y. Causal Association between Periodontal Diseases and Cardiovascular Diseases. Genes (Basel). 2021;13(1):13. Available from: https://pubmed.ncbi.nlm.nih.gov/35052354
  12. Nocini R, Favaloro EJ, Sanchis-Gomar F, Lippi G. Periodontitis, coronary heart disease and myocardial infarction: treat one, benefit all. Blood Coagul & Fibrinolysis. 2020;31(6):339–45. Available from: http://dx.doi.org/10.1097/mbc.0000000000000928
  13. Joshi C, Mezincescu A, Gunasekara M, Rudd A, Botchorichvili H, Sabir S, et al. Myocardial infarction risk is increased by periodontal pathobionts: a cross-sectional study. Sci Rep. 2022;12(1):18608. Available from: https://pubmed.ncbi.nlm.nih.gov/36329042
  14. Zardawi F, Gul S, Abdulkareem A, Sha A, Yates J. Association Between Periodontal Disease and Atherosclerotic Cardiovascular Diseases: Revisited. Front Cardiovasc Med. 2021;7:625579. Available from: https://pubmed.ncbi.nlm.nih.gov/33521070
  15. Wettersten N, Maisel A. Role of Cardiac Troponin Levels in Acute Heart Failure. Card Fail Rev. 2015;1(2):102–6. Available from: https://pubmed.ncbi.nlm.nih.gov/28785441
  16. Heeschen C, Hamm CW, Bruemmer J, Simoons ML. Predictive value of C-reactive protein and troponin T in patients with unstable angina: a comparative analysis. J Am Coll Cardiol. 2000;35(6):1535–42. Available from: http://dx.doi.org/10.1016/s0735-1097(00)00581-7
  17. Januzzi Jr JL, Suchindran S, Hoffmann U, Patel MR, Ferencik M, Coles A, et al. Single-Molecule hsTnI and Short-Term Risk in Stable Patients With Chest Pain. J Am Coll Cardiol. 2019;73(3):251–60. Available from: https://pubmed.ncbi.nlm.nih.gov/30678753
  18. Peacock WF, De Marco T, Fonarow GC, Diercks D, Wynne J, Apple FS, et al. Cardiac Troponin and Outcome in Acute Heart Failure. N Engl J Med. 2008;358(20):2117–26. Available from: http://dx.doi.org/10.1056/nejmoa0706824
  19. Tanglay Y, Twerenbold R, Lee G, Wagener M, Honegger U, Puelacher C, et al. Incremental Value of a Single High-sensitivity Cardiac Troponin I Measurement to Rule Out Myocardial Ischemia. Am J Med. 2015;128(6):638–46. Available from: http://dx.doi.org/10.1016/j.amjmed.2015.01.009
  20. Ramasamy I. Highly sensitive Troponin I assay in the diagnosis of coronary artery disease in patients with suspected stable angina. World J Cardiol. 2021;13(12):745–57. Available from: https://pubmed.ncbi.nlm.nih.gov/35070116
  21. Sandoval Y, Apple FS, Mahler SA, Body R, Collinson PO, Jaffe AS, et al. High-Sensitivity Cardiac Troponin and the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guidelines for the Evaluation and Diagnosis of Acute Chest Pain. Circulation. 2022;146(7):569–81. Available from: http://dx.doi.org/10.1161/circulationaha.122.059678
  22. Hua Y, Zhang W, Li X. The Value of Soluble ST2 in Predicting Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients. Heart Surg Forum. 2023;26(5). Available from: http://dx.doi.org/10.59958/hsf.6669
  23. Prayogo AA, Suryantoro SD, Savitri M, Hendrata WM, Wijaya AY, Pikir BS. High Sensitivity Troponin T as Complementary Modality for Determining Doxorubicin Regimen Cardiotoxicity in Non-Hodgkin Lymphoma Patients. Adv Pharm Bull. 2020/10/19. 2022;12(1):163–8. Available from: https://pubmed.ncbi.nlm.nih.gov/35517883
  24. Mueller D, Puelacher C, Honegger U, Walter JE, Badertscher P, Schaerli N, et al. Direct Comparison of Cardiac Troponin T and I Using a Uniform and a Sex-Specific Approach in the Detection of Functionally Relevant Coronary Artery Disease. Clin Chem. 2018;64(11):1596–606. Available from: http://dx.doi.org/10.1373/clinchem.2018.286971
  25. D. Y-M. Prévalence du cancer chez les 15 ans et plus. Option/Bio. 2014;25(513):9. Available from: http://dx.doi.org/10.1016/s0992-5945(14)71875-6
  26. Madsen DM, Diederichsen ACP, Hosbond SE, Gerke O, Mickley H. Diagnostic and prognostic value of a careful symptom evaluation and high sensitive Troponin in patients with suspected stable angina pectoris without prior cardiovascular disease. Atherosclerosis. 2017;258:131–7. Available from: http://dx.doi.org/10.1016/j.atherosclerosis.2016.11.030
  27. Marfil-Álvarez R, Mesa F, Arrebola-Moreno A, Ramírez-Hernández JA, Magán-Fernández A, O’Valle F, et al. Acute myocardial infarct size is related to periodontitis extent and severity. J Dent Res. 2014/08/19. 2014;93(10):993–8. Available from: https://pubmed.ncbi.nlm.nih.gov/25139359
  28. Loo WY, Yue Y, Fan C, Bai L, Dou Y, Wang M, et al. Comparing serum levels of cardiac biomarkers in cancer patients receiving chemotherapy and subjects with chronic periodontitis. J Transl Med. 2012/09/19. 2012;10 Suppl 1(Suppl 1):S5–S5. Available from: https://pubmed.ncbi.nlm.nih.gov/23046680
  29. Hashem AS, Ismail HS, Patil SR, Alam MK. Evaluation the prevalence of moderate chronic periodontitis among smokers and non-smokers in Aljouf province , Kingdom Of Saudi Arabia. Int J Hum Heal Sci. 2018;2(3):145. Available from: http://dx.doi.org/10.31344/ijhhs.v2i3.43
  30. Dietrich T, Sharma P, Walter C, Weston P, Beck J. The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Periodontol. 2013;84(4S). Available from: http://dx.doi.org/10.1902/jop.2013.134008
  31. Wulandari P, Widkaja D, Nasution AH, Syahputra A, Gabrina G. Association between age, gender and education level with the severity of periodontitis in pre-elderly and elderly patients. Dent J. 2022;55(1):16–20. Available from: http://dx.doi.org/10.20473/j.djmkg.v55.i1.p16-20
  32. Byun SH, Lee S, Kang SH, Choi HG, Hong SJ. Cross-Sectional Analysis of the Association between Periodontitis and Cardiovascular Disease Using the Korean Genome and Epidemiology Study Data. Int J Environ Res Public Health. 2020;17(14):5237. Available from: https://pubmed.ncbi.nlm.nih.gov/32698486
  33. Adamson PD, Hunter A, Madsen DM, Shah AS V, McAllister DA, Pawade TA, et al. High-Sensitivity Cardiac Troponin I and the Diagnosis of Coronary Artery Disease in Patients With Suspected Angina Pectoris. Circ Cardiovasc Qual Outcomes. 2018;11(2):e004227–e004227. Available from: https://pubmed.ncbi.nlm.nih.gov/29444926
  34. Punj A, Shenoy SB, Subramanyam K. Comparison of Endothelial Function in Healthy Patients and Patients With Chronic Periodontitis and Myocardial Infarction. J Periodontol. 2017;88(12):1234–43. Available from: http://dx.doi.org/10.1902/jop.2017.160748
  35. Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C, et al. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int J Mol Sci. 2019;20(6):1414. Available from: https://pubmed.ncbi.nlm.nih.gov/30897827
  36. Schenkein HA, Papapanou PN, Genco R, Sanz M. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontol 2000. 2020;83(1):90–106. Available from: http://dx.doi.org/10.1111/prd.12304
  37. Gurav AN. The implication of periodontitis in vascular endothelial dysfunction. Eur J Clin Invest. 2014;44(10):1000–9. Available from: http://dx.doi.org/10.1111/eci.12322
  38. Goteiner D, Craig RG, Ashmen R, Janal MN, Eskin B, Lehrman N. Endotoxin Levels Are Associated With High‐Density Lipoprotein, Triglycerides, and Troponin in Patients With Acute Coronary Syndrome and Angina: Possible Contributions From Periodontal Sources. J Periodontol. 2008;79(12):2331–9. Available from: http://dx.doi.org/10.1902/jop.2008.080068
  39. Tian J, Hu S, Han X, Dong N, Yu H, Sun Y, et al. Lipopolysaccharide-Induced Proliferation of the Vasa Vasorum in a Rabbit Model of Atherosclerosis as Evaluated by Contrast-Enhanced Ultrasound Imaging and Histology. Inflammation. 2012;35(4):1530–7. Available from: http://dx.doi.org/10.1007/s10753-012-9468-z
  40. Sánchez-Siles M, Rosa-Salazar V, Salazar-Sánchez N, Camacho-Alonso F. Periodontal disease as a risk factor of recurrence of venous thromboembolic disease: a prospective study. Acta Odontol Scand. 2014;73(1):8–13. Available from: http://dx.doi.org/10.3109/00016357.2014.920514
  41. Vavik V, Pedersen EKR, Svingen GFT, Tell GS, Schartum-Hansen H, Aakre KM, et al. Usefulness of Higher Levels of Cardiac Troponin T in Patients With Stable Angina Pectoris to Predict Risk of Acute Myocardial Infarction. Am J Cardiol. 2018;122(7):1142–7. Available from: http://dx.doi.org/10.1016/j.amjcard.2018.06.027
  42. Caselli C, Prontera C, Liga R, De Graaf MA, Gaemperli O, Lorenzoni V, et al. Effect of Coronary Atherosclerosis and Myocardial Ischemia on Plasma Levels of High-Sensitivity Troponin T and NT-proBNP in Patients With Stable Angina. Arterioscler Thromb Vasc Biol. 2016;36(4):757–64. Available from: http://dx.doi.org/10.1161/atvbaha.115.306818
  43. Kirthi AAAK, Yasmin AAADA, Artha IMJR, Bhargah A. Hipertensi sebagai prediktor kejadian kardiovaskular mayor pada pasien infark miokard akut pada tahun 2018 di RSUP Sanglah Denpasar, Bali-Indonesia. Intisari Sains Medis. 2019;10(3). Available from: https://isainsmedis.id/index.php/ism/article/view/443
  44. Bhargah A, Jayantika IGABK, Prabawa IPY, Manuaba IBP. Spontaneous conversion to sinus rhythm in atrial fibrillation after dual antiplatelet and anticoagulant therapy in patients with unstable angina. Bali Med J. 2020;9(3):664-7. Available from: https://ww.balimedicaljournal.org/index.php/bmj/article/view/2011
  45. Artha IMJR, Bakta IM, Manuaba IBP, Wita IW, Rohman MS, Astawa INM, Bhargah A. The Effects of Percutaneous Coronary Intervention on Biomarkers and Quality of Life in Patients With Chronic Total Coronary Artery Obstruction. Cardiol Res. 2023;14(1):69-78. Available from: doi: 10.14740/cr1455.
  46. Artha IMJR, Bhargah A, Dharmawan NK, Pande UW, Triyana KA, Mahariski PA, Yuwono J, Bhargah V, Prabawa IPY, Manuaba IBAP, Rina IK. High level of individual lipid profile and lipid ratio as a predictive marker of poor glycemic control in type-2 diabetes mellitus. Vasc Health Risk Manag. 2019;15:149-157. Available from: doi: 10.2147/VHRM.S209830.
  47. Handoyo V, Pertiwi GAR, Prabawa IPY, Manuaba IBAP, Bhargah A, Budiana IPG. Management of ST-elevation myocardial infarction in the setting of anterior epistaxis: focused on antiplatelet and antithrombotic therapies. Int Med Case Rep J. 2019;12:33-38. Available from: doi: 10.2147/IMCRJ.S189370.

How to Cite

Sitompul, S. I., Aryati, Budi Susetyo Pikir, & Monika Estherlita Sinta. (2023). Role of cardiac marker troponin I in chronic periodontitis with coronary artery disease. Bali Medical Journal, 12(3), 3229–3235. https://doi.org/10.15562/bmj.v12i3.4891

HTML
0

Total
0

Share

Search Panel

Sanggap Indra Sitompul
Google Scholar
Pubmed
BMJ Journal


Aryati
Google Scholar
Pubmed
BMJ Journal


Budi Susetyo Pikir
Google Scholar
Pubmed
BMJ Journal


Monika Estherlita Sinta
Google Scholar
Pubmed
BMJ Journal