Detection of periodontal microorganisms in coronary atheromatous plaque specimens of myocardial infarction patients: A systematic review and meta-analysis.
Level 4 - case-series / case-control
Systematic review of observational tissue detection studies and case series
PubMed 31983534 · doi:10.1016/j.tcm.2019.12.005
What was done
A systematic review and meta-analysis was conducted following PRISMA guidelines across six databases for studies published between 2007 and 2017. The review evaluated the prevalence of periodontal microorganisms in coronary atheroma and/or aspirated clot specimens from myocardial infarction patients with periodontal disease. Fourteen eligible publications were identified.
What was found
Twelve of the 14 included studies reported the presence of periodontal bacterial DNA in coronary atherosclerotic plaque specimens. Overall, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were the most frequently detected species. Meta-analysis showed that the prevalence of P. gingivalis was significantly higher than A. actinomycetemcomitans in coronary atheromatous plaque samples (exact numbers and effect sizes not reported in the abstract). Non-periodontal bacterial DNA (including Pseudomonas fluorescens, Streptococcus species, and Chlamydia pneumoniae) was also identified.
Why it matters
These findings support the hypothesis that periodontal bacteria can systemically translocate from inflamed oral pockets into coronary atheromatous plaques. However, the presence of bacterial DNA alone does not determine whether these organisms actively drive plaque pathology or are merely incidental bystanders.
Limits
The abstract does not report pooled percentage prevalence values, confidence intervals, or total participant/sample numbers. Detection was based on bacterial DNA presence rather than viable organism culture or direct causal mechanisms.
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