Myocardial infarction risk is increased by periodontal pathobionts: a cross-sectional study

C Joshi, A Mezincescu, M Gunasekara, A Rudd, H Botchorichvili, S Sabir, C Dospinescu, A Noman, D Hogg, G Cherukara, D McLernon, K Hijazi* (Corresponding Author), D Dawson* (Corresponding Author)

*Corresponding author for this work

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To establish the role of periodontal pathobionts as a risk factor for myocardial infarction, we examined the contribution of five periodontal pathobionts and their virulence genes’ expressions to myocardial injury (Troponin-I) and coronary artery disease burden (SYNTAX-I scores) using hierarchical linear regression. Pathobiont loads in subgingival-plaques and intra-coronary-thrombi were compared. Troponin-I release increased with one 16S rRNA gene copy/ng DNA of Porphyromonas gingivalis (β = 6.8×10-6, 95% CI = 1.1×10-7-2.1×10-5), one-fold increased expressions of fimA (β = 14.3, 95% CI = 1.5-27.1), bioF-3 (β = 7.8, 95% CI = 1.1-12.3), prtH (β = 1107.8, 95% CI = 235.6-2451.3), prtP (β = 6772.8, 95% CI = 2418.7-11126.9), ltxA (β = 1811.8, 95% CI = 217.1-3840.8), cdtB (β = 568.3, 95% CI = 113.4-1250.1), all p < 0.05. SYNTAX-I score increased with one 16S rRNA gene copy/ng DNA of Porphyromonas gingivalis (β = 3.8×10-9, 95% CI = 3.6×10-10-1.8×10-8), one-fold increased expressions of fimA (β = 1.2, 95% CI = 1.1-2.1), bioF-3 (β = 1.1, 95% CI = 1-5.2), prtP (β = 3, 95% CI = 1.3-4.6), ltxA (β = 1.5, 95% CI = 1.2-2.5), all p < 0.05. Within-subject Porphyromonas gingivalis and Tannerella forsythia from intra-coronary-thrombi and subgingival-plaques correlated (rho = 0.6, p < 0.05). Higher pathobiont load and/or upregulated virulence are risk factors for myocardial infarction.
Trial registration: Identifier: NCT04719026
Original languageEnglish
Article number18608
Number of pages11
JournalScientific Reports
Early online date3 Nov 2022
Publication statusPublished - Dec 2022

Bibliographical note

Acknowledgements The authors thank the laboratory and administrative staff at the Institute of Dentistry and the Institute of Medical Sciences of the University of Aberdeen for their help. We are grateful to Dr Pirkko Pussinen (Institute of Dentistry, University of Turku, Finland) for sharing the P. gingivalis-antibody positive serum samples and a detailed ELISA protocol. We would like to thank all Consultant Cardiologists at Aberdeen Royal Infirmary for identifying suitable patients during the acute on-call: Dr Andrew Hannah, Dr Andrew Stewart, Dr Adelle Dawson, Dr Deepak Garg, Dr Paul Broadhurst, Dr Nicola Ryan. Lastly, we are grateful to all the participating patients.

Funding: “Periodontal health in patients acutely admitted for myocardial infarction study” was funded by the Elphinstone Award to Dr Hijazi. Dr Dawson is supported by the British Heart Foundation (FS/RTF/20/30009, NH/19/1/34595, PG/18/35/33786, CS/17/4/32960, PG/15/88/31780, PG/17/64/33205), Chest Heart and Stroke Scotland (19/53), Tenovus Scotland (G.18.01), Friends of Anchor and Grampian NHS-Endowments.

Data Availability Statement

The corresponding author has full access to all the datasets used for analysis and it will be shared at a reasonable request.


  • Humans
  • Cross-Sectional Studies
  • RNA, Ribosomal, 16S/genetics
  • Troponin I
  • Porphyromonas gingivalis
  • Myocardial Infarction/epidemiology
  • DNA


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