Dataset Information

Poor oral health and risk of incident myocardial infarction: A prospective cohort study of Swedish adults, 1973-2012.

ABSTRACT: Previous studies provide conflicting evidence as to whether there is an association between poor oral health and an increased risk of myocardial infarction. The aim of the study was to deepen knowledge of the association between oral health and myocardial infarction risk using a large (n?=?20,133), prospective, and population-based cohort in Uppsala, Sweden. Oral health was determined during a clinical dental examination at entry into the cohort in 1973/74. Individuals were followed through linkage with the Swedish National Patient Register, Cause of Death Register and Emigration Register. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) for total, non-fatal and fatal myocardial infarction events. Increased risks of total, non-fatal and fatal myocardial infarction events among individuals with fewer reference teeth at examination, more dental plaque and a borderline significant increased risk among individuals with oral lesions were observed. Adjustment for multiple potential confounding factors did not change the results appreciably. However, the observed HRs generally decreased towards one when the analysis was confined to non-tobacco users only. The results from this study indicate that poor oral health is associated with a slightly increased risk of myocardial infarction; however, these results may be partly explained by residual confounding.

SUBMITTER: Wilson K

PROVIDER: S-EPMC6068156 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Poor oral health and risk of incident myocardial infarction: A prospective cohort study of Swedish adults, 1973-2012.

Wilson Katherine K Liu Zhiwei Z Huang Jiaqi J Roosaar Ann A Axéll Tony T Ye Weimin W

Scientific reports 20180731 1

Previous studies provide conflicting evidence as to whether there is an association between poor oral health and an increased risk of myocardial infarction. The aim of the study was to deepen knowledge of the association between oral health and myocardial infarction risk using a large (n = 20,133), prospective, and population-based cohort in Uppsala, Sweden. Oral health was determined during a clinical dental examination at entry into the cohort in 1973/74. Individuals were followed through link ...[more]

PMID: 30065312

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Project description:OBJECTIVES:Compare gender disparities in ST-elevation myocardial infarction (STEMI) regarding first medical contact (FMC) and prehospital delay times and explore factors associated with prehospital delay in men and women separately. DESIGN:Cross-sectional study based on medical records and a validated questionnaire. Eligible patients were enrolled within 24?hours after admittance to hospital. SETTING:Patients were included from November 2012 to January 2014 from five Swedish hospitals with catheterisation facilities 24/7. PARTICIPANTS:340 men and 109 women aged between 31 and 95 years completed the survey. MAIN OUTCOME MEASURES:FMC were divided into five possible contacts: primary healthcare centre by phone or directly, national advisory nurse by phone, emergency medical services (EMS) and emergency room directly. Two parts of prehospital delay times were studied: time from symptom onset to FMC and time from symptom onset to diagnostic ECG. RESULTS:Women more often called an advisory nurse as FMC (28% vs 18%, p=0.02). They had a longer delay until FMC, 90 (IQR 39-221) vs 66 (28-161) min, p=0.04 and until ECG, 146 (68-316) vs 103 (61-221) min, p=0.03. Men went to hospital because of believing they were stricken by an MI to a higher extent than women did (25% vs 15%, p=0.04) and were more often recommended to call EMS by bystanders (38% vs 22%, p<0.01). Hesitating about going to hospital and experiencing pain in the stomach/back/shoulders were factors associated with longer delays in women. Believing the symptoms would disappear or interpreting them as nothing serious were corresponding factors in men. In both genders bystanders acting by contacting EMS explained shorter prehospital delays. CONCLUSIONS:In STEMI, women differed from men in FMC and they had longer delays. This was partly due to atypical symptoms and a longer decision time. Bystanders acted more promptly when men than when women fell ill. Public knowledge of MI symptoms, and how to act properly, still seems insufficient.

Dataset Information

Poor oral health and risk of incident myocardial infarction: A prospective cohort study of Swedish adults, 1973-2012.

Publications

Poor oral health and risk of incident myocardial infarction: A prospective cohort study of Swedish adults, 1973-2012.

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