Risk of Myocardial Infarction and Ischemic Stroke after Dental Treatments.
The association between invasive dental treatments (IDTs) and a short-term risk of myocardial infarction (MI) and ischemic stroke (IS) remains controversial. Bacterial dissemination from the oral cavity and systemic inflammation linked to IDT can induce a state of acute vascular dysfunction. The aim of study is to investigate the relation of IDTs to MI and IS by using case-only study designs to analyze data from a large Taiwanese cohort. A nationwide population-based study was undertaken by using the case-crossover and self-controlled case series design to analyze the Taiwanese National Health Care Claim database. Conditional logistic regression model and conditional Poisson regression model were used to estimate the risks of MI/IS. In addition, we used burn patients as negative controls to explore the potential effect of residual confounding. In total, 123,819 MI patients and 327,179 IS patients in the case-crossover design and 117,655 MI patients and 298,757 IS patients were included in the self-controlled case series design. Results from both study designs showed that the risk of MI within the first 24 wk after IDT was not significantly different from or close to unity except for a modest risk during the first week for patients without other comorbidities (odds ratios [95% confidence intervals] of 1.31 [1.08-1.58] and 1.15 [1.01-1.31] for 3 d and 7 d, respectively). We also observed no association between IDTs and IS, or the risk ratio was close to unity. IDTs did not appear to be associated with a transient risk of MI and IS in the Taiwanese population, with consistent findings from both case-only study designs. However, we cannot exclude that dental infections and diseases may yield a long-term risk of MI and IS.
['Chen|T T|TT|', "D'Aiuto|F|F|", 'Yeh|Y C|YC|', 'Lai|M S|MS|', 'Chien|K L|KL|', 'Tu|Y K|YK|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002545:Brain Ischemia D016022:Case-Control Studies D018592:Cross-Over Studies D003729:Dental Care D005260:Female D006801:Humans D007348:Insurance, Health D008297:Male D008875:Middle Aged D009055:Mouth D009203:Myocardial Infarction D019647:Oral Surgical Procedures D012189:Retrospective Studies D012307:Risk Factors D020521:Stroke D013624:Taiwan
case-only study case-crossover self-controlled case series cardiovascular diseases epidemiologic studies retrospective studies