Objective: Periodontitis may contribute to vascular damage, resulting in the destabilization of atherosclerotic plaque leading to acute coronary syndrome (ACS). In this study, we explored the effect of non-surgical periodontal treatment (NSPT) on cardiovascular blood biomarkers and gingival crevicular fluid (GCF) neutrophil elastase (NE) and α1-proteinase inhibitor (α-1PI) levels in periodontitis (P) participants with and without ACS.
Materials And Methods: Medical and dental examinations were performed to diagnose ACS and periodontitis, respectively. Seventeen patients with diagnosis of ACS and periodontitis were included in this study, as a test group (group ACS). Twenty-six age and sex-matched control patients with periodontitis (group P) were otherwise systemically healthy. Both groups received NSPT. Plasma levels of cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), C-reactive protein (CRP), GCF NE activity, GCF α-PI levels, and GCF NE/α1-PI rates were measured at baseline, at1 and 3 months after NSPT.
Results: GCF NE activity/time (μU/30s) decreased significantly at 3 month compared to baseline values in the Group P after NSPT. First and 3 months after NSPT, in the Group P GCF α-PI activity/time (pg/30s) was significantly higher than the Group ACS. Moreover GCF NE/α-PI rates decreased significantly compared to baseline values at 1 and 3 months after NSPT in the group P.
Conclusion: NSPT yields decrease in NE/α-PI rates. NE and its possible interactions with α-PI may play a crucial role in both periodontitis and ACS. GCF α1PI activity/time (U/30s) can be a potential biomarker in management of periodontitis associated with ACS.
Clinical Relevance: The GCF α1-PI reduction may alter the immune-inflammatory response in patients with periodontitis and thus increase the risk of ACS.
Trial Registration: Thai Clinical Trials.gov (NCT04785235).
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