{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:31:05Z","timestamp":1787495465198,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Patients with stroke\/transient ischemic attack and periodontal disease (PD) are at increased risk for cardiovascular events. PD treatments that can improve stroke risk factors were tested if they might assist patients with cerebrovascular disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>In this multicenter phase II trial, patients with stroke\/transient ischemic attack and moderately severe PD were randomly assigned to intensive or standard PD treatment arms. The primary outcome measure was a composite of death, myocardial infarction, and recurrent stroke, as well as adverse events. Secondary outcome included changes in stroke risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      A total of 1209 patients with stroke\/transient ischemic attack were screened, of whom 481 met the PD eligibility criteria; 280 patients were randomized to intensive arm (n=140) and standard arm (n=140). In 12-month period, primary outcome occurred in 11 (8%) in the intensive arm and 17 (12%) in the standard arm. The intensive arm was nonsuperior to the standard arm (hazard ratio, 0.65 [95% CI, 0.30\u20131.38]) with similar rates of adverse events (sepsis 2.1% versus 0.7%; dental bleeding 1.4% versus 0%; and infective endocarditis 0.7% versus 0%). Secondary-outcome improvements were noted in both arms with diastolic blood pressure and high-density lipoprotein cholesterol (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In patients with recent stroke\/transient ischemic attack and PD, intensive PD treatment was not superior to standard PD treatment in prevention of stroke\/myocardial infarction\/death. Fewer events were noted in the intensive arm and the 2 arms were comparable in the safety outcomes. Secondary-outcome measures showed a trend toward improvement, with significant changes noted in diastolic blood pressure and high-density lipoprotein in both the treatment arms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.122.042047","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T05:00:38Z","timestamp":1691384438000},"page":"2214-2222","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Periodontal Disease Treatment After Stroke or Transient Ischemic Attack: The PREMIERS Study, a Randomized Clinical Trial"],"prefix":"10.1161","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0886-2364","authenticated-orcid":true,"given":"Souvik","family":"Sen","sequence":"first","affiliation":[{"name":"Department of Neurology, School of Medicine, Prisma Health and University of South Carolina, Columbia (S.S., J.M., E.M., M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4042-3847","authenticated-orcid":true,"given":"James","family":"Curtis","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Prisma Health Medical Group, Columbia, SC (J.C., D.H., C.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6974-6095","authenticated-orcid":true,"given":"David","family":"Hicklin","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Prisma Health Medical Group, Columbia, SC (J.C., D.H., C.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9585-4337","authenticated-orcid":true,"given":"Cynthia","family":"Nichols","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Prisma Health Medical Group, Columbia, SC (J.C., D.H., C.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saundra","family":"Glover","sequence":"additional","affiliation":[{"name":"Arnold School of Public Health, University of South Carolina, Columbia (S.G., A.T.M., J.W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1045-5079","authenticated-orcid":true,"given":"Anwar T.","family":"Merchant","sequence":"additional","affiliation":[{"name":"Arnold School of Public Health, University of South Carolina, Columbia (S.G., A.T.M., J.W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W.","family":"Hardin","sequence":"additional","affiliation":[{"name":"Arnold School of Public Health, University of South Carolina, Columbia (S.G., A.T.M., J.W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6340-627X","authenticated-orcid":true,"given":"Makenzie","family":"Logue","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Prisma Health and University of South Carolina, Columbia (S.S., J.M., E.M., M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9910-8086","authenticated-orcid":true,"given":"Jaclyn","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Prisma Health and University of South Carolina, Columbia (S.S., J.M., E.M., M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9577-2286","authenticated-orcid":true,"given":"Emma","family":"Mason","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Prisma Health and University of South Carolina, Columbia (S.S., J.M., E.M., M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0658-8752","authenticated-orcid":true,"given":"David Y.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology (D.Y.H.), University of North Carolina, Chapel Hill."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano","family":"Susin","sequence":"additional","affiliation":[{"name":"Division of Comprehensive Oral Health\/Periodontology (C.S., K.M., J.B.), University of North Carolina, Chapel Hill."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2332-1774","authenticated-orcid":true,"given":"Kevin","family":"Moss","sequence":"additional","affiliation":[{"name":"Division of Comprehensive Oral Health\/Periodontology (C.S., K.M., J.B.), University of North Carolina, Chapel Hill."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-8311","authenticated-orcid":true,"given":"James","family":"Beck","sequence":"additional","affiliation":[{"name":"Division of Comprehensive Oral Health\/Periodontology (C.S., K.M., J.B.), University of North Carolina, Chapel Hill."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","volume-title":"Underlying Cause of Death 1999-2014","author":"Statistics NCfH","year":"2016","unstructured":"Statistics NCfH. Underlying Cause of Death 1999-2014. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2016."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000152"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12415"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.06.024"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2008.07.037"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12323"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030427"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12171"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2021.105511"},{"key":"e_1_3_3_11_2","first-page":"121","article-title":"PeRiodontal Treatment to Eliminate Minority Inequality and Rural Disparities in Stroke (PREMIERS): a multicenter, randomized, controlled study.","volume":"2","author":"Redd KT","year":"2019","unstructured":"Redd, KT, Phillips, ST, McMillian, B, Giamberardino, L, Hardin, J, Glover, S, Merchant, A, Susin, C, Beck, JD, Offenbacher, S, et al. PeRiodontal Treatment to Eliminate Minority Inequality and Rural Disparities in Stroke (PREMIERS): a multicenter, randomized, controlled study. Int J Cerebrovasc Dis Stroke. 2019;2:121.","journal-title":"Int J Cerebrovasc Dis Stroke"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1159\/000323226"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3109\/00016356408993968"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1902\/annals.1999.4.1.1"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000277487.04281.db"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12975-011-0072-6"},{"key":"e_1_3_3_17_2","first-page":"147","article-title":"Comparison of gingival index and sulcus bleeding index as indicators of periodontal status.","volume":"60","author":"Benamghar L","year":"1982","unstructured":"Benamghar, L, Penaud, J, Kaminsky, P, Abt, F, Martin, J. Comparison of gingival index and sulcus bleeding index as indicators of periodontal status. Bull World Health Organ. 1982;60:147\u2013151.","journal-title":"Bull World Health Organ"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/00220345211009767"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/75.4.800"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2182"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa063186"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.06.018"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvz201"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz646"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002514"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/0022034509337479"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.4103\/0972-124X.107471"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.31.8.1882"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.26402\/jpp.2019.6.01"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.122.042047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T17:23:33Z","timestamp":1748539413000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.122.042047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1161\/STROKEAHA.122.042047"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.122.042047","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"2022-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-14","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}