ArticleAmerican heart journal2021
Periodontal Disease, Atrial Fibrillation and Stroke.
Article in American heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 5 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Causal association between periodontitis and systemic diseases: a systematic review and meta-analysis of mendelian randomization studies.BMC oral health · 2026Pooled it
- Association of periodontal disease with risk atrial fibrillation: systematic review.BMC oral health · 2025Pooled it
- Anti-Porphyromonas gingivalis Antibody Levels in Patients With Stroke and Atrial Fibrillation: A Systematic Review and Meta-Analysis.Clinical and experimental dental research · 2024Pooled it
- The role of periodontitis in the development of atherosclerotic cardiovascular disease in participants with the components of metabolic syndrome: a systematic review and meta-analysis.Clinical oral investigations · 2024Pooled it
- Effects of Oral Inflammatory Diseases and Oral Hygiene on Atrial Fibrillation: A Systematic Review.International journal of clinical practice · 2023Pooled it
- From Periodontal Inflammation to Atrial Fibrillation: Molecular Links Through Thrombospondin-1, Galectin-3, and SGLT2-Related Pathways.International journal of molecular sciences · 2026Review
- Article
- Observational
- The Interplay Between Periodontitis and Atrial Fibrillation: Inflammation as a Common Pathophysiological Bridge.International journal of molecular sciences · 2026Review
- Relationship between periodontitis and atrial fibrillation recurrence after ablation: a systematic review.Frontiers in cardiovascular medicine · 2026Review
- The 2-Step Mendelian Randomisation Study Assesses Genetic Causality and Potential Mediators of Periodontal Disease and Atrial Fibrillation.International dental journal · 2025Article
- The Association Between Periodontal Disease and Acute Coronary Syndrome-A Clinical Analysis.Journal of clinical medicine · 2025Article
- The Impact of Periodontitis on Cardiovascular Disease: Mechanisms, Evidence, and Therapeutic Implications.International journal of dentistry · 2025Review
- Periodontitis impacts on thrombotic diseases: from clinical aspect to future therapeutic approaches.International journal of oral science · 2024Review
- The Molecular Comorbidity Network of Periodontal Disease.International journal of molecular sciences · 2024Article
- Oral Microbiome Dysbiosis as a Risk Factor for Stroke: A Comprehensive Review.Microorganisms · 2024Review
- Exploring Periodontal Conditions, Salivary Markers, and Systemic Inflammation in Patients with Cardiovascular Diseases.Biomedicines · 2024Article
- Periodontal Treatment During the Blanking Period Improves the Outcome of Atrial Fibrillation Ablation.Journal of the American Heart Association · 2024Article
- Oral anaerobe bacteria-a common risk for cardiovascular disease and mortality and some forms of cancer?Frontiers in oral health · 2024Review
- Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundWe recently described the association between periodontal disease (PD) and stroke risk. PURPOSE: The purpose of this study was to test the association between PD, dental care utilization and incident atrial fibrillation (AF), as well as AF as a mediator to PD- stroke association.
methodsIn dental cohort of the Atherosclerosis Risk in Communities Study (ARIC), participants without prior AF underwent full-mouth periodontal measurements. PD was defined on an ordinal scale as healthy (referent), mild, moderate and severe. In ARIC main cohort, participants were classified as regular or episodic dental care users. These patients were followed for AF, over 17 years. Cox proportional hazards models adjusted for AF risk factors were used to study relationships between PD severity, dental care utilization and AF. Mediation analysis was used to test if AF mediated the PD- stroke association.
resultsIn dental ARIC cohort, 5,958 were assessed without prior AF, 754 were found to have AF. Severe PD was associated with AF on both univariable (crude HR, 1.54; 95% CI, 1.26-1.87) and multivariable (adjusted HR, 1.31, 95% CI, 1.06-1.62) analyses. Mediation analysis suggested AF mediates the association between PD and stroke. In the main ARIC cohort, 9,666 participants without prior AF were assessed for dental care use, 1558 were found to have AF. Compared with episodic users, regular users had a lower risk for AF on univariable (crude HR, 0.82, 95% CI, 0.74-0.90) and multivariable (adjusted HR, 0.88, 95% CI, 0.78-0.99) analyses.
conclusionsPD is associated with AF. The association may explain the PD-stroke risk. Regular users had a lower risk of incident AF compared with episodic users.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.