Tooth loss is independently associated with poor outcomes in stable coronary heart disease

Abstract

Objective

We investigated associations between self-reported tooth loss and cardiovascular outcomes in a global stable coronary heart disease cohort.

Methods

We examined 15,456 patients from 39 countries with stable coronary heart disease (prior myocardial infarction, prior revascularisation or multivessel coronary heart disease) in the STABILITY trial. At baseline, patients reported number of teeth (26–32 (all), 20–25, 15–19, 1–14 and no teeth) and were followed for 3.7 years. Cox regression models adjusted for cardiovascular risk factors and socioeconomic status, determined associations between tooth loss level (26–32 teeth: lowest level; no teeth: highest level) and cardiovascular outcomes.

Results

After adjustment, every increase in tooth loss level was associated with an increased risk of the primary outcome, the composite of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke (hazard ratio 1.06; 95% confidence interval 1.02–1.10), cardiovascular death (1.17; 1.10–1.24), all-cause death (1.16; 1.11–1.22) and non-fatal or fatal stroke (1.14; 1.04–1.24), but not with non-fatal or fatal myocardial infarction (0.99; 0.94–1.05). Having no teeth, compared to 26–32 teeth, entailed a significantly higher risk of the primary outcome (1.27 (1.08, 1.49)), cardiovascular death (1.85 (1.45, 2.37), all-cause death (1.81 (1.50, 2.20)) and stroke (1.67 (1.15, 2.39)).

Conclusions

In this large global cohort of patients with coronary heart disease, self-reported tooth loss predicted adverse cardiovascular outcomes and all-cause death independent of cardiovascular risk factors and socioeconomic status.