Periodontal disease has been shown to be associated with incident stroke. We investigated whether periodontal disease is independently associated with recurrent vascular events and certain inflammatory markers in stroke/TIA patients. In this prospective longitudinal hospital-based cohort study, periodontal disease was assessed in stroke/TIA patients. High periodontal disease was defined as the highest tertile of extent (% of sites) with attachment loss ≥ 5 mm. Serum interleukin-6, high sensitivity C-reactive protein and soluble intracellular adhesion molecule-1 were measured. The patients were followed for recurrent vascular events-stroke, TIA, myocardial infarction and vascular death. In the 106 patients that were evaluated, 40 (38%) showed high periodontal disease and 27 (26%) had recurrent vascular events over a median of 24 months (range 12–24 months). High periodontal disease patients had higher levels of interleukin-6 (p=0.01) and soluble intracellular adhesion molecule-1 (p=0.03). High periodontal disease was associated with recurrent vascular events before (Log rank p=0.01, hazard ratio 2.6, 95% CI, 1.2–5.7) and after adjustment for significant confounders -age and stroke status (Hazard Ratio 2.5, 95% confidence interval, 1.1 to 5.5, p=0.03); adjustment for possible confounders age, males, years of education and cardioembolic strokes (hazard ratio 2.8, 95% confidence interval, 1.2–6.5, p=0.02); and adjustment for propensity score that accounted for all potential measured confounders (hazard ratio 2.8, 95% confidence interval,1.2–6.5, p=0.02). There is an independent association between high periodontal disease and recurrent vascular events in stroke/TIA patients. High periodontal disease is also associated with higher serum levels of interleukin-6 and soluble intracellular adhesion molecule-1
