Association between Acute Myocardial Infarction and Periodontitis: A Review of the Literature.

Cardiovascular disease (CVD), particularly acute myocardial infarction (AMI), is the leading cause of death worldwide. In India, myocardial events are expected to be the fastest growing cause of death between 2005 and 2015. Thus, in order to prevent and manage the onset of the prevailing AMI epidemic, there is a crucial need to explore different dependent and independent risk factors of AMI, as well as its relationship with other systemic diseases and ill health conditions. One such possible relationship could be an association between AMI and periodontal diseases.The aim of this study was to review the existing literature to assess the strength of association between AMI and periodontitis in the context of Indian, particularly North Indian, populations and to outline key knowledge gaps in this field.Review of the literature clearly indicates that evidence on the association between periodontitis and AMI in Indian populations, as well as other populations worldwide, is limited. The number of studies done so far is relatively low. Further, inadequate sample size, retrospective data analyses, potential residual confounding factors, inconsistent definitions of exposure and outcome variables, and reported diversity in results, are some of the other key limitations.Insufficient evidence is available to justify that periodontal interventions can prevent the onset or progression of acute myocardial events. More longitudinal clinical trials and case-control studies with well controlled confounding factors and valid outcome and exposure measures are needed for determining the true association between the conditions.