Pro-inflammatory and hemostatic factors in patients with minor ischemic stroke and periodontal disease: 616.8-005:616-002:616.151.5

Abstract

Summary. Background. Hyperproduction of pro-inflammatory factors, dysregulation of interleukin balance, hemostasis activation are important components of the pathogenesis of ischemic stroke (IS) and odontogenic inflammatory pathology. Objective: to evaluate the state of oral hygiene and the impact of dental treatment on the levels of inflammatory cascade markers, hemostasis and quality of life in patients with minor IS and periodontal diseases. Patients/Methods. An observational longitudinal compara- tive study was performed, 83 patients aged 55 to 73 years with minor IS from 6 to 18 hours ago were examined. The patients were divided into 2 groups: the main group (68 patients aged 68 [64; 73] years) with minor IS and periodontal disease received basic therapy, professional oral hygiene and dental treatment; the comparison group (15 patients aged 59 [55; 66] years) with minor IS without dental diseases received only basic therapy. The blood levels of C-reactive protein (CRP) and intercellular adhesion molecule type 1 (ICAM-1), interleukins (IL) — IL-6 and IL-10, tumor necrosis factor-α (TNF-α), fibrinogen, tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) were determined. The SF-36 health questionnaire was used to assess the quality of life. Results. In patients with minor IS and periodontal disease, the leukocyte count, CRP, TNF-α, IL-6, and ICAM-1 values were significantly higher compared to patients without odontogenic inflammatory diseases. In addition, decreased IL-10 level was revealed in the main group that was also characterized by increased blood thrombogenic activity — increased fibrinogen and PAI-1 levels and a decreased t-PA content. After professional oral hygiene and dental treatment in the main group, decreased leuko- cytes number, CRP, TNF-α and ICAM-1 and increased IL-10 level were noted due to decreasing of local bacterial load. A decrease in hemostatic activation parameters (fibrinogen and PAI-1) was also revealed. Assessing of quality of life of patients with minor IS and periodontal diseases showed a statistically significant increaseing “role functioning associated with the emotional state” and “intensity of pain syndrome” indicators after dental treatment. Conclusions. The study shows that interdisciplinary management of patients with minor IS, including professional oral hygiene and dental treatment, reduces the levels of systemic inflammation biomarkers and hemostatic activation, and improves quality of life.

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