Abstract
Objective
Oral diseases, including periodontitis and stomatitis, are highly prevalent worldwide and reportedly associated with the development of cardiovascular disease. Given the high rate of stomatitis in individuals wearing dentures, denture users may be at high risk of poor cardiovascular outcomes. We therefore investigated whether or not the use of dentures is associated with a poor clinical outcome in patients with acute myocardial infarction (MI).
Methods
This two-center retrospective observational study was conducted between January 2012 and March 2020. A total of 1,046 patients with acute MI who underwent primary percutaneous coronary intervention were divided into two groups according to denture use status. The primary outcomes included ischemic events (cardiovascular death, recurrent MI, and ischemic stroke) and major bleeding (Bleeding Academic Research Consortium type 3 or 5).
Results
Of the 1,046 patients with acute MI, 387 (37.0%) used dentures. An older age and prior MI were associated with an increased likelihood of denture use. During the mean 660-day follow-up period, ischemic and major bleeding events occurred in 169 (16.2%) and 102 (9.8%) patients, respectively. Denture use was associated with an increased risk of ischemic events, whereas no significant intergroup differences were observed in major bleeding outcomes. The results were similar among patients ≥75 years old.
Conclusion
More than one-third of the patients with acute MI wore dentures. Our findings suggest that denture use is significantly associated with an increased risk of ischemic events but not bleeding outcomes after acute MI.
Keywords: denture, acute myocardial infarction, percutaneous coronary intervention
Introduction
Acute myocardial infarction (MI) is among the leading causes of mortality globally (1). Oral diseases are also prevalent, affecting more than 3.5 billion people worldwide (2). In the last decades, evidence has accumulated linking oral diseases, especially periodontitis and stomatitis, to atherosclerotic cardiovascular disease, including acute MI, via inflammatory and immune-mediated mechanisms (3,4). The prevalence of individuals wearing dentures has been increasing as societies are aging, and denture-related stomatitis affects up to 70% of patients in this population (5). Thus, patients wearing dentures may be at a higher risk of developing cardiovascular disease.
Indeed, a large-scale observational study in Sweden indicated that denture use was significantly associated with a higher prevalence of cardiovascular diseases (6). However, the use of dentures was evaluated based on a patient questionnaire in a cross-sectional Swedish study, and evidence regarding the relationship between denture use and cardiovascular disease is still lacking.
The present study therefore investigated whether or not denture use is associated with a poor clinical outcomes in patients with acute MI undergoing contemporary primary percutaneous coronary intervention (PCI).
Materials and Methods
Study design and population
This retrospective observational study was conducted at two tertiary referral hospitals: Chiba University Hospital and the Eastern Chiba Medical Center. From January 2012 to March 2020, 1,102 patients with acute MI, including ST-segment elevation and non-ST-segment elevation MI, underwent primary PCI. Details of the registry have been previously described (7-10). In brief, acute MI was defined according to the fourth universal definition of MI (11). All patients included in the present analysis underwent primary PCI per local standard practice with the predominant use of dual antiplatelet therapy, intracoronary imaging, and contemporary drug-eluting stents (12-17). Patients for whom denture information was missing (n=52) and those who underwent cardiac surgery immediately after primary PCI (n=4) were excluded. Thus, 1,046 patients with acute MI were included in the present study.
This study was conducted in accordance with the Declaration of Helsinki, and informed consent was obtained via opt-out approach. This study was approved by the ethics committees of Chiba University Hospital and the Eastern Chiba Medical Center.
Definitions and endpoint
At the two participating hospitals, trained nurses routinely evaluated denture use during the index hospitalization for acute MI. A denture was defined as a complete or partial removable prosthetic dental appliance used to replace one or more teeth. Patients were divided into two groups based on denture use. In addition, because the rate of denture use increases in older people, who are currently defined as those ≥75 years old in Japan according to the proposal from the Japan Gerontological Society and the Japan Geriatrics Society (18), a subgroup analysis of patients ≥75 years old was performed.
The primary endpoint of the present study was ischemic (cardiovascular death, recurrent MI, and ischemic stroke) and major bleeding (Bleeding Academic Research Consortium type 3 or 5) events adjudicated according to the consensus documents (11,19,20).
Statistical analyses
Statistical assessments were performed using the JMP Pro software program, ver. 15.0.0 (SAS Institute, Cary, USA). Data are expressed as the mean±standard deviation or frequency (%). Continuous variables were compared using Student's t-test, while categorical variables were assessed using the chi-square analysis or Fisher's exact test. To explore factors associated with denture use in the study population, a multivariable analysis was performed using a logistic regression analysis with 11 baseline characteristics: age, sex, body mass index, hypertension, diabetes, dyslipidemia, current smoking, prior MI, atrial fibrillation, renal function, and hemoglobin level. A Kaplan-Meier analysis was used to calculate the time to clinical endpoints, and the log-rank test was used to compare intergroup differences. Kaplan-Meier analyses were performed on the overall study population and in those ≥75 years old. A Cox proportional-hazard model was used to estimate unadjusted and adjusted hazard ratios with corresponding 95% confidence intervals of ischemic and major bleeding events using the same variables for predicting denture use. Time to first event data were analyzed using a Kaplan-Meier analysis and the Cox proportional-hazard model. Statistical significance was defined as a 2-sided p value <0.05.
Results
Of the 1,046 patients with acute MI undergoing primary PCI, 387 (37.0%) used dentures. Table 1 shows the patients' baseline characteristics. Patients with dentures tended to be older, be women, and have anemia and an impaired renal function (Table 1). Even among patients ≥75 years old (n=319), those with dentures were older than their counterparts (81.2±4.7 vs. 80.0±3.9 years, p=0.01) (Supplementary material). Table 2 shows that an older age and prior MI were independently associated with an increased likelihood of denture use.
Table 1.
Baseline Characteristics.
| Variable | All (n=1,046) |
Denture use | p value | |||||
|---|---|---|---|---|---|---|---|---|
| YES (n=387) | NO (n=659) | |||||||
| Age (years) | 67.3±12.1 | 73.1±9.3 | 63.9±12.3 | <0.001 | ||||
| Age ≥75 years | 319 (30.7%) | 178 (46.0%) | 141 (21.4%) | <0.001 | ||||
| Men | 801 (76.6%) | 278 (71.8%) | 523 (79.4%) | 0.006 | ||||
| Body mass index (kg/m2) | 24.2±3.7 | 23.6±3.5 | 24.6±3.8 | <0.001 | ||||
| Hypertension | 711 (67.9%) | 285 (73.6%) | 426 (64.6%) | 0.003 | ||||
| Diabetes | 390 (37.3%) | 153 (39.5%) | 237 (36.0%) | 0.26 | ||||
| Dyslipidemia | 651 (59.4%) | 225 (58.1%) | 426 (64.6%) | 0.04 | ||||
| Current smoker | 347 (33.2%) | 104 (26.9%) | 243 (36.9%) | <0.001 | ||||
| Prior MI | 68 (6.5%) | 35 (9.0%) | 33 (5.0%) | 0.01 | ||||
| Atrial fibrillation | 69 (6.6%) | 32 (8.3%) | 37 (5.6%) | 0.12 | ||||
| eGFR (mL/min/1.73 m2) | 63.5±24.3 | 59.8±23.7 | 65.8±24.4 | <0.001 | ||||
| Hemoglobin (g/dL) | 13.7±2.2 | 13.3±2.3 | 13.9±2.2 | <0.001 | ||||
| Type of MI | 1.00 | |||||||
| STEMI | 706 (67.5%) | 261 (67.4%) | 445 (67.5%) | |||||
| NSTEMI | 340 (32.5%) | 126 (32.6%) | 214 (32.4%) | |||||
| Killip class on admission | 0.25 | |||||||
| I | 715 (68.4%) | 251 (64.9%) | 464 (70.4%) | |||||
| II | 94 (9.0%) | 41 (10.6%) | 53 (8.0%) | |||||
| III | 59 (5.6%) | 25 (6.5%) | 34 (5.2%) | |||||
| IV | 178 (17.0%) | 70 (18.1%) | 108 (16.4%) | |||||
| Cardiac arrest on admission | 119 (11.4%) | 41 (10.6%) | 78 (11.8%) | 0.61 | ||||
| Culprit vessel | 0.58 | |||||||
| RCA | 316 (30.2%) | 116 (30.0%) | 200 (30.3%) | |||||
| LMT/LAD | 532 (50.9%) | 196 (50.7%) | 336 (51.0%) | |||||
| LCX | 165 (15.8%) | 59 (15.3%) | 106 (16.1%) | |||||
| Undetermined | 33 (3.2%) | 16 (4.1%) | 17 (2.6%) | |||||
| Intracoronary imaging | 1,017 (97.2%) | 377 (97.4%) | 640 (97.1%) | 0.85 | ||||
| Drug-eluting stent | 953 (91.1%) | 350 (90.4%) | 603 (91.5%) | 0.57 | ||||
eGFR: estimated glomerular filtration rate, LAD: left anterior descending artery, LCX: left circumflex, LMT: left main trunk, MI: myocardial infarction, NSTEMI: non ST-segment elevation myocardial infarction, RCA: right coronary artery, STEMI: ST-segment elevation myocardial infarction
Table 2.
Factors Associated with the Use of Denture.
| Variable | Univariable | Multivariable | ||||||
|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | p value | OR (95% CI) | p value | |||||
| Age (years) | 1.08 (1.06-1.09) | <0.001 | 1.08 (1.06-1.10) | <0.001 | ||||
| Men | 0.66 (0.50-0.89) | 0.006 | 0.87 (0.61-1.23) | 0.43 | ||||
| Body mass index (kg/m2) | 0.93 (0.89-0.96) | <0.001 | 0.99 (0.95-1.03) | 0.57 | ||||
| Hypertension | 1.53 (1.16-2.02) | 0.003 | 1.24 (0.90-1.70) | 0.19 | ||||
| Diabetes | 1.16 (0.90-1.51) | 0.25 | 1.20 (0.89-1.60) | 0.23 | ||||
| Dyslipidemia | 0.76 (0.59-0.98) | 0.04 | 0.82 (0.61-1.10) | 0.18 | ||||
| Current smoker | 0.63 (0.48-0.83) | 0.001 | 1.35 (0.96-1.90) | 0.08 | ||||
| Prior MI | 1.89 (1.15-3.09) | 0.01 | 1.85 (1.07-3.21) | 0.03 | ||||
| Atrial fibrillation | 1.52 (0.93-2.48) | 0.10 | 1.05 (0.62-1.72) | 0.85 | ||||
| eGFR (mL/min/1.73 m2) | 0.99 (0.99-1.00) | <0.001 | 1.00 (1.00-1.01) | 0.48 | ||||
| Hemoglobin (g/dL) | 0.88 (0.83-0.93) | <0.001 | 1.01 (0.94-1.10) | 0.72 | ||||
CI: confidence interval, eGFR: estimate glomerular filtration rate, MI: myocardial infarction, OR: odds ratio
During the mean follow-up period of 660 days, ischemic and major bleeding events occurred in 169 (16.2%) and 102 (9.8%) patients, respectively (Table 3). A Kaplan-Meier analysis showed that denture use was associated with an increased risk of ischemic events, while no significant difference was observed in major bleeding outcomes (Fig. 1). The results were similar among patients ≥75 years old (Fig. 2). Cox proportional hazard regression analyses showed that denture use was not significantly associated with an increased risk of ischemic events according to a multivariable analysis of the entire study population (Table 4) but was significantly associated with an increased risk among those ≥75 years old (Table 5). Denture use was not significantly related to the risk of major bleeding events in the multivariable analysis of the entire study population or of patients ≥75 years old (Table 6, 7).
Table 3.
Clinical Outcomes.
| Variable | All (n=1,046) |
Denture use | p value | |||||
|---|---|---|---|---|---|---|---|---|
| YES (n=387) | NO (n=659) | |||||||
| Ischemic events | 169 (16.2%) | 74 (19.1%) | 95 (14.4%) | 0.046 | ||||
| Cardiovascular death | 102 (9.8%) | 50 (12.9%) | 52 (7.9%) | 0.008 | ||||
| Recurrent MI | 44 (4.2%) | 16 (4.1%) | 28 (4.3%) | 0.93 | ||||
| Ischemic stroke | 37 (3.5%) | 13 (3.4%) | 24 (3.6%) | 0.81 | ||||
| Major bleeding events | 102 (9.8%) | 40 (10.3%) | 62 (9.4%) | 0.63 | ||||
| BARC 3 | 93 (8.9%) | 36 (9.3%) | 57 (8.7%) | 0.72 | ||||
| BARC 5 | 9 (0.9%) | 4 (1.0%) | 5 (0.8%) | 0.73 | ||||
BARC: Bleeding Academic Research Consortium, MI: myocardial infarction
Figure 1.
Cumulative incidence of ischemic and bleeding events in patients with versus without dentures.
Figure 2.
Cumulative incidence of ischemic and bleeding events in patients ≥75 years old with versus without dentures.
Table 4.
Multivariable Analysis for Ischemic Events in the Entire Study Population.
| Variable | Univariable | Multivariable | ||||||
|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | p value | HR (95% CI) | p value | |||||
| Age (years) | 1.02 (1.01-1.04) | 0.001 | 1.00 (0.98-1.02) | 0.96 | ||||
| Men | 0.86 (0.61-1.22) | 0.41 | 1.05 (0.71-1.55) | 0.81 | ||||
| Body mass index (kg/m2) | 0.98 (0.93-1.02) | 0.26 | 1.02 (0.98-1.07) | 0.35 | ||||
| Hypertension | 1.00 (0.72-1.38) | 0.98 | 0.78 (0.54-1.18) | 0.17 | ||||
| Diabetes | 1.31 (0.97-1.78) | 0.08 | 1.30 (0.94-1.80) | 0.11 | ||||
| Dyslipidemia | 0.53 (0.39-0.71) | <0.001 | 0.62 (0.45-0.86) | 0.005 | ||||
| Current smoker | 0.60 (0.42-0.86) | 0.005 | 0.80 (0.54-1.19) | 0.27 | ||||
| Prior MI | 1.27 (0.74-2.20) | 0.39 | 1.11 (0.62-2.01) | 0.72 | ||||
| Atrial fibrillation | 1.35 (0.78-2.34) | 0.28 | 1.15 (0.66-2.02) | 0.61 | ||||
| eGFR (mL/min/1.73 m2) | 0.98 (0.97-0.98) | <0.001 | 0.98 (0.98-0.99) | <0.001 | ||||
| Hemoglobin (g/dL) | 0.82 (0.77-0.87) | <0.001 | 0.89 (0.82-0.97) | 0.007 | ||||
| Denture | 1.40 (1.03-1.90) | 0.03 | 1.19 (0.85-1.67) | 0.31 | ||||
CI: confidence intervals, eGFR: estimated glomerular filtration rate, HR: hazard ratio, MI: myocardial infarction
Table 5.
Multivariable Analysis for Ischemic Events in Patients Aged ≥75 Years.
| Variable | Univariable | Multivariable | ||||||
|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | p value | HR (95% CI) | p value | |||||
| Age (years) | 1.05 (0.99-1.10) | 0.09 | 1.03 (0.98-1.10) | 0.27 | ||||
| Men | 1.30 (0.75-2.24) | 0.35 | 1.73 (0.93-3.22) | 0.09 | ||||
| Body mass index (kg/m2) | 0.94 (0.87-1.02) | 0.16 | 0.97 (0.88-1.06) | 0.47 | ||||
| Hypertension | 0.72 (0.41-1.27) | 0.26 | 0.65 (0.34-1.23) | 0.19 | ||||
| Diabetes | 1.37 (0.83-2.25) | 0.22 | 1.53 (0.89-2.62) | 0.12 | ||||
| Dyslipidemia | 0.72 (0.44-1.18) | 0.19 | 0.93 (0.53-1.63) | 0.80 | ||||
| Current smoker | 1.06 (0.51-2.24) | 0.87 | 1.13 (0.51-2.49) | 0.77 | ||||
| Prior MI | 1.13 (0.45-2.81) | 0.80 | 0.82 (0.28-2.43) | 0.72 | ||||
| Atrial fibrillation | 1.04 (0.48-2.29) | 0.92 | 1.07 (0.47-2.41) | 0.88 | ||||
| eGFR (mL/min/1.73 m2) | 0.98 (0.97-1.00) | 0.007 | 0.99 (0.97-1.00) | 0.03 | ||||
| Hemoglobin (g/dL) | 0.83 (0.74-0.94) | 0.002 | 0.86 (0.75-0.99) | 0.03 | ||||
| Denture | 1.84 (1.08-3.14) | 0.02 | 2.13 (1.17-3.90) | 0.01 | ||||
CI: confidence intervals, eGFR: estimated glomerular filtration rate, HR: hazard ratio, MI: myocardial infarction
Table 6.
Multivariable Analysis for Bleeding Events in the Entire Study Population.
| Variable | Univariable | Multivariable | ||||||
|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | p value | HR (95% CI) | p value | |||||
| Age (years) | 1.01 (1.00-1.03) | 0.10 | 0.99 (0.97-1.01) | 0.39 | ||||
| Men | 0.59 (0.39-0.90) | 0.01 | 0.65 (0.40-1.03) | 0.07 | ||||
| Body mass index (kg/m2) | 0.97 (0.91-1.02) | 0.21 | 1.01 (0.95-1.07) | 0.74 | ||||
| Hypertension | 0.89 (0.59-1.35) | 0.58 | 0.69 (0.43-1.09) | 0.11 | ||||
| Diabetes | 1.14 (0.77-1.70) | 0.51 | 1.10 (0.72-1.69) | 0.66 | ||||
| Dyslipidemia | 0.53 (0.36-0.78) | 0.001 | 0.58 (0.37-0.89) | 0.01 | ||||
| Current smoker | 0.77 (0.55-1.18) | 0.22 | 1.07 (0.65-1.75) | 0.79 | ||||
| Prior MI | 2.10 (1.17-3.76) | 0.01 | 2.23 (1.18-4.23) | 0.01 | ||||
| Atrial fibrillation | 1.13 (0.52-2.43) | 0.76 | 1.04 (0.48-2.28) | 0.92 | ||||
| eGFR (mL/min/1.73 m2) | 0.98 (0.97-0.99) | <0.001 | 0.98 (0.97-0.99) | <0.001 | ||||
| Hemoglobin (g/dL) | 0.79 (0.73-0.86) | <0.001 | 0.85 (0.77-0.95) | 0.004 | ||||
| Denture | 1.12 (0.75-1.66) | 0.59 | 0.97 (0.62-1.51) | 0.89 | ||||
CI: confidence intervals, eGFR: estimated glomerular filtration rate, HR: hazard ratio, MI: myocardial infarction
Table 7.
Multivariable Analysis for Bleeding Events in Patients Aged ≥75 Years.
| Variable | Univariable | Multivariable | ||||||
|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | p value | HR (95% CI) | p value | |||||
| Age (years) | 0.98 (0.90-1.06) | 0.54 | 0.95 (0.87-1.03) | 0.20 | ||||
| Men | 0.59 (0.30-1.13) | 0.11 | 0.53 (0.24-1.17) | 0.12 | ||||
| Body mass index (kg/m2) | 0.91 (0.82-1.02) | 0.10 | 0.96 (0.85-1.07) | 0.45 | ||||
| Hypertension | 0.67 (0.32-1.38) | 0.28 | 0.67 (0.29-1.58) | 0.36 | ||||
| Diabetes | 0.78 (0.39-1.56) | 0.48 | 0.68 (0.31-1.48) | 0.33 | ||||
| Dyslipidemia | 0.59 (0.31-1.14) | 0.12 | 0.54 (0.25-1.18) | 0.12 | ||||
| Current smoker | 0.90 (0.32-2.55) | 0.84 | 1.10 (0.37-3.23) | 0.87 | ||||
| Prior MI | 2.76 (1.15-6.63) | 0.02 | 2.93 (0.98-8.75) | 0.054 | ||||
| Atrial fibrillation | 0.50 (0.12-2.08) | 0.34 | 0.58 (0.14-2.50) | 0.47 | ||||
| eGFR (mL/min/1.73 m2) | 0.98 (0.97-1.00) | 0.07 | 0.98 (0.97-1.00) | 0.07 | ||||
| Hemoglobin (g/dL) | 0.76 (0.65-0.89) | <0.001 | 0.79 (0.65-0.96) | 0.02 | ||||
| Denture | 1.67 (0.85-3.40) | 0.13 | 1.72 (0.79-3.74) | 0.17 | ||||
CI: confidence intervals, eGFR: estimated glomerular filtration rate, HR: hazard ratio, MI: myocardial infarction
Discussion
The present two-center registry showed that more than one-third of patients with acute MI, especially elderly patients, wore dentures. Denture use was significantly associated with an increased risk of ischemic events and bleeding outcomes, particularly in patients ≥75 years old. To our knowledge, this is the first longitudinal study to investigate the prognostic impact of dentures in patients with acute MI in a contemporary setting.
Oral health and cardiovascular disease
Societies are aging globally, and oral diseases, including periodontitis and stomatitis, are highly prevalent worldwide (2). Oral and dental diseases are linked to bacterial translocation, inflammatory processes, immune activation, platelet aggregation, thrombosis, and endothelial dysfunction, presumably resulting in the development of atherosclerosis and cardiovascular diseases (3). A previous study suggested that similar inflammatory pathways might exist in the arterial intima and periodontium, including local macrophage activation and low-density lipoprotein-mediated foam cell formation (21). An association between oral diseases and atherosclerotic cardiovascular diseases, including acute MI, has been demonstrated (22,23). Given that denture use is common, especially in the elderly, as shown in the present study, and leads to denture-related stomatitis in up to 70% of patients (5), patients wearing dentures may be at an increased risk of cardiovascular events. Furthermore, patients with dentures are also likely to have cardiovascular risk factors, such as metabolic syndrome. A recent randomized controlled trial demonstrated the potential of dental interventions to improve surrogate markers of metabolic syndrome (24). However, few studies have focused on the relationship between denture use and cardiovascular outcomes. A Swedish cross-sectional questionnaire survey showed that denture use was significantly associated with an increased risk of cardiovascular events after adjusting for confounding factors (odds ratio, 1.57; 95% confidence interval, 1.13-2.20; p=0.008) (6), although evidence of this relationship is lacking otherwise.
Denture and acute MI
In the present study, patients with acute MI were included, representing a population at risk of developing further cardiovascular complications. The prevalence of denture use was 37.0% in the overall study population (mean age, 67.3 years old) and 55.8% in patients ≥75 years old, which may be in line with recent reports from Japan (25). After acute MI, patients using dentures were at increased risk of cardiovascular events, whereas their bleeding risk was not increased. Although a causative relationship has not yet been established, the presence of dentures may be associated with ischemic events, possibly through inflammatory mechanisms (3). Obviously, an increased age increases one's likelihood of denture use, as shown in the present study. Thus, our results may have been confounded by age and concomitant traditional cardiovascular risks. Although consistent results were shown in patients ≥75 years old (i.e., increased ischemic risk in patients with dentures), confounding biases cannot be eliminated. However, because bleeding outcomes were similar between patients with and without dentures in the overall study population as well as in the subset of patients ≥75 years old despite intergroup differences in ischemic risk, our results might be reasonable.
In addition, the results of the multivariate analysis of the subgroup of patients ≥75 years old showed that denture use was independently associated with a higher risk of ischemic events. Therefore, we believe that denture use may be associated with an increased risk of ischemic events. In addition, prior MI may be associated with denture use (Table 2), supporting the results of the Swedish cross-sectional survey (6). Given that dental interventions were recently reported to improve surrogate endpoints, including risk factor control and the endothelial function (4,24,26), the identification of denture use and subsequent application of appropriate therapeutic strategies might improve clinical outcomes in patients with acute MI. Further studies are warranted to clarify the relationship between denture use and cardiovascular outcomes and investigate potential therapeutic strategies in patients wearing dentures to reduce clinical event rates.
Study limitations
The present study had several limitations. This retrospective study had a moderate sample size. Because of the nature of observational studies, the medical treatment, including antithrombotic therapy, was chosen by the treating physicians. In the present study, only denture status was observed. In other words, detailed data on dentures and related factors (e.g., number, type, and location; and denture-related stomatitis) were not available. Although the results of a multivariable analysis in patients ≥75 years old indicated a significant relationship between denture use and ischemic outcomes, the association may not be established because of the nature of the subgroup analysis. Future large-scale investigations are needed to evaluate the association between denture use and ischemic and bleeding outcomes in patients with cardiovascular disease. In addition, data on inflammatory markers, such as C-reactive protein levels, were not available in the present study.
Conclusion
In the present two-center registry, denture users versus non-users were at an increased risk of ischemic events after primary PCI for acute MI, while bleeding outcomes were similar between the groups. The multivariable analysis did not identify denture use as a significant factor associated with ischemic events in the entire study population; however, it was a predictor of ischemic events among patients ≥75 years old. Further studies are warranted to confirm these results.
The authors state that they have no Conflict of Interest (COI).
Supplementary Material
eGFR: estimated glomerular filtration rate, LAD: left anterior descending artery, LCX: left circumflex, LMT: left main trunk, MI: myocardial infarction, NSTEMI: non ST-segment elevation myocardial infarction, RCA: right coronary artery, STEMI: ST-segment elevation myocardial infarction.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
eGFR: estimated glomerular filtration rate, LAD: left anterior descending artery, LCX: left circumflex, LMT: left main trunk, MI: myocardial infarction, NSTEMI: non ST-segment elevation myocardial infarction, RCA: right coronary artery, STEMI: ST-segment elevation myocardial infarction.