Int J Cardiol：牙周治疗降低房颤风险

牙周治疗带来的口腔卫生改善与心血管事件风险降低有关。由此，台北荣民总院林幸荣和江晨恩等人研究了牙周治疗与房颤（AF）的关系。结果显示，牙周治疗可以降低房颤风险，研究在2013年2月27日发表于《国际心脏病学杂志》。
2000年，研究人员从台湾“全民健康保险研究资料库”中挑选出28,909名年龄不低于60周岁的受试者，所有受试者均无心律失常病史。其中连续三年（1998-2000）至少每年接受1次牙周治疗的受试者编为暴露组（n=3391），另13,564名年龄、性别和潜在疾病匹配，且不接受牙周治疗的受试者编为未暴露组，研究终点为新发AF的出现。
研究发现，随访4.6±1.1年间共478名受试者（2.8%）发生了AF。暴露组AF发生率低于未暴露组（2.2% vs 3.0%；p值= 0.017）。根据年龄、性别和伴随疾病调整后，多变量分析发现牙周治疗与AF风险降低有关（危险比=0.671，95% CI= 0.524–0.859；p值=0.002）。暴露组中，每年牙周治疗不止一次的受试者发生AF的危险比为0.340（95% CI =0.247–0.489；p值< 0.001）。
本项研究显示，接受牙周治疗的患者AF风险较低，通过牙周治疗改善口腔卫生也许是预防AF一种简单有效的手段。

Dental scaling and atrial fibrillation: A nationwide cohort study.
BACKGROUND
Improvement of oral hygiene through dental scaling was associated with a decreased risk of cardiovascular events. The goal of the present study was to investigate whether dental scaling can reduce the risk of atrial fibrillation (AF).
METHODS
In year 2000, a total of 28,909 subjects who were age 60 or more without past history of cardiac arrhythmias were identified from the "National Health Insurance Research Database" in Taiwan. Among these subjects, those who have received dental scaling at least 1 time/year for 3 consecutive years (1998-2000) were selected to be the exposed group (n=3391). A total of 13,564 age, sex and underlying disease-matched subjects without receiving dental scaling were identified to be the non-exposed group. The study endpoint was the occurrence of new-onset AF.
RESULTS
During a follow-up of 4.6±1.1years, 478 participants (2.8%) developed AF. The exposed group had a lower AF occurrence rate than non-exposed group (2.2% versus 3.0%; p value=0.017). After an adjustment with age, gender, and comorbidities in the multivariate analysis, dental scaling was associated with a reduced risk of AF (hazard ratio=0.671, 95% CI=0.524-0.859; p value=0.002). Among the exposed group, the hazard ratio in developing AF was 0.340 (95% CI=0.247-0.489; p value <0.001) when subjects received 1 more dental scaling per year.
CONCLUSIONS
The risk of AF was lower in subjects receiving dental scaling. Improvement of oral hygiene by dental scaling may be a simple and useful way to prevent AF.