{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:16:12Z","timestamp":1791317772660,"version":"4.3.1"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2016,2,9]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The relationship between periodontitis (PD) and cardiovascular disease is debated. PD is common in patients with cardiovascular disease. It has been postulated that PD could be causally related to the risk for cardiovascular disease, a hypothesis tested in the Periodontitis and Its Relation to Coronary Artery Disease (PAROKRANK) study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Eight hundred five patients (&lt;75 years of age) with a first myocardial infarction (MI) and 805 age- (mean 62\u00b18), sex- (male 81%), and area-matched controls without MI underwent standardized dental examination including panoramic x-ray. The periodontal status was defined as healthy (\u226580% remaining bone) or as mild-moderate (from 79% to 66%) or severe PD (&lt;66%). Great efforts were made to collect information on possibly related confounders (\u2248100 variables). Statistical comparisons included the Student pairwise\n              <jats:italic>t<\/jats:italic>\n              test and the McNemar test in 2\u00d72 contingency tables. Contingency tables exceeding 2\u00d72 with ranked alternatives were tested by Wilcoxon signed rank test. Odds ratios (95% confidence intervals) were calculated by conditional logistic regression. PD was more common (43%) in patients than in controls (33%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). There was an increased risk for MI among those with PD (odds ratio, 1.49; 95% confidence interval, 1.21\u20131.83), which remained significant (odds ratio, 1.28; 95% confidence interval, 1.03\u20131.60) after adjusting for variables that differed between patients and controls (smoking habits, diabetes mellitus, years of education, and marital status).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In this large case\u2013control study of PD, verified by radiographic bone loss and with a careful consideration of potential confounders, the risk of a first MI was significantly increased in patients with PD even after adjustment for confounding factors. These findings strengthen the possibility of an independent relationship between PD and MI.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.115.020324","type":"journal-article","created":{"date-parts":[[2016,1,14]],"date-time":"2016-01-14T10:18:22Z","timestamp":1452766702000},"page":"576-583","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":276,"title":["Periodontitis Increases the Risk of a First Myocardial Infarction"],"prefix":"10.1161","volume":"133","author":[{"given":"Lars","family":"Ryd\u00e9n","sequence":"first","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K\u00e5re","family":"Buhlin","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Ekstrand","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"de Faire","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Holmer","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbro","family":"Kjellstr\u00f6m","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertil","family":"Lindahl","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Norhammar","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5ke","family":"Nygren","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"N\u00e4sman","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilminie","family":"Rathnayake","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabet","family":"Svenungsson","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Klinge","sequence":"additional","affiliation":[{"name":"From Departments of Medicine K2 (L.R., U.d.F., B.K., A.N., E.S.), Dental Medicine (K.B., E.E., A.G., J.H., N.R., B.K.), and Division of Cardiovascular Epidemiology IMM (U.d.F.), Karolinska Institutet, Stockholm, Sweden; Department Medical Sciences, Uppsala University, Sweden (B.L.); Department of Clinical Sciences Danderyd, Karolinska Institutet, Stockholm, Sweden (\u00c5.N.); Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden (P.N.); and Faculty of Odontology, Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu299"},{"key":"e_1_3_4_3_2","volume-title":"European Cardiovascular Disease Statistics 2012","author":"Nichols M","year":"2012","unstructured":"Nichols M, Townsend N, Luengo-Fernandez R, Leal J, Gray A, Scarborough P, Rayner M. European Cardiovascular Disease Statistics 2012. Brussels, Belgium: European Heart Network and Sophia Antipolis, France: European Society of Cardiology; 2012. ISBN 978-2-9537898-1-2."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17018-9"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm1102-1257"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra043430"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0022034514552491"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0757.2002.290111.x"},{"key":"e_1_3_4_9_2","first-page":"1","article-title":"Papers.","volume":"4","author":"1999 International Workshop for a Classification of Periodontal Diseases and Conditions","year":"1999","unstructured":"1999 International Workshop for a Classification of Periodontal Diseases and Conditions. Papers. Oak Brook, Illinois, October 30-November 2, 1999. Ann Periodontol. 1999;4:i, 1\u2013112.","journal-title":"Ann Periodontol"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67728-8"},{"key":"e_1_3_4_11_2","first-page":"197","article-title":"Periodontal diseases and cardiovascular events: meta-analysis of observational studies.","volume":"59","author":"Blaizot A","year":"2009","unstructured":"Blaizot A, Vergnes JN, Nuwwareh S, Amar J, Sixou M. Periodontal diseases and cardiovascular events: meta-analysis of observational studies. Int Dent J. 2009;59:197\u2013209.","journal-title":"Int Dent J"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0022034510375281"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12171"},{"key":"e_1_3_4_14_2","first-page":"271","article-title":"Periodontal therapy and biomarkers related to cardiovascular risk.","volume":"59","author":"Moura Foz A","year":"2010","unstructured":"Moura Foz A, Alexandre Romito G, Manoel Bispo C, Luciancencov Petrillo C, Patel K, Suvan J, D\u2019Aiuto F. Periodontal therapy and biomarkers related to cardiovascular risk. Minerva Stomatol. 2010;59:271\u2013283.","journal-title":"Minerva Stomatol"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.03.035"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa063186"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31825719f3"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.198804"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.187397"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31826e1058"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.134.4.382"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2005.76.4.544"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2008.01225.x"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-051x.2002.290312.x"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-051x.2001.028009865.x"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.306.6879.688"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2004.75.9.1274"},{"key":"e_1_3_4_28_2","first-page":"341","volume-title":"In: Chronic Periodontitis \u2013 Prevention, Diagnostics and Treatment","author":"The Swedish Council on Technology Assessment in Health Care (SBU)","year":"2004","unstructured":"The Swedish Council on Technology Assessment in Health Care (SBU). Chronic periodontitis as a risk factor for the development of other diseases. In: Chronic Periodontitis \u2013 Prevention, Diagnostics and Treatment. SBU-report no 169. 2004: 341\u2013376. (in Swedish). ISBN 91-87890-96-8."},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009197.pub2"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12007"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.1999.00554.x"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200103000-00014"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH08-09-0612"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09089-X"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2004.01371.x"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2006.050459"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1988.tb01564.x"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1038\/dmfr.18.2.2635121"},{"key":"e_1_3_4_39_2","first-page":"25","article-title":"The relationship between probing bone loss and standardized radiographic analysis.","volume":"20","author":"Kili\u00e7 AR","year":"1998","unstructured":"Kili\u00e7 AR, Efeoglu E, Yilmaz S, Orgun T. The relationship between probing bone loss and standardized radiographic analysis. Periodontal Clin Investig. 1998;20:25\u201332.","journal-title":"Periodontal Clin Investig"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0722.2000.00729.x"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2014.130612"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1216063"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1902\/annals.1998.3.1.151"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.3402\/jom.v6.23408"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.115.020324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:38:55Z","timestamp":1715582335000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.115.020324"}},"subtitle":["A Report From the PAROKRANK Study"],"short-title":[],"issued":{"date-parts":[[2016,2,9]]},"references-count":43,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,2,9]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.115.020324"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.115.020324","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,9]]},"assertion":[{"value":"2015-07-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-12-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-01-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}