Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke

Background and purpose. Risk of acute ischemic stroke has been associated with carotid artery atherosclerosis as well as with periodontal disease. We studied whether oral pathology or carotid atherosclerosis was associated with the presence and quantity of bacterial DNA in their aspirated thrombi. M...

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Main Authors: Olli Patrakka, Helena Mehtonen, Sari Tuomisto, Juha-Pekka Pienimäki, Jyrki Ollikainen, Heini Huhtala, Tanja Pessi, Niku Oksala, Terho Lehtimäki, Jorma Järnstedt, Mika Martiskainen, Pekka J. Karhunen
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Stroke Research and Treatment
Online Access:http://dx.doi.org/10.1155/2021/5402764
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author Olli Patrakka
Helena Mehtonen
Sari Tuomisto
Juha-Pekka Pienimäki
Jyrki Ollikainen
Heini Huhtala
Tanja Pessi
Niku Oksala
Terho Lehtimäki
Jorma Järnstedt
Mika Martiskainen
Pekka J. Karhunen
author_facet Olli Patrakka
Helena Mehtonen
Sari Tuomisto
Juha-Pekka Pienimäki
Jyrki Ollikainen
Heini Huhtala
Tanja Pessi
Niku Oksala
Terho Lehtimäki
Jorma Järnstedt
Mika Martiskainen
Pekka J. Karhunen
author_sort Olli Patrakka
collection DOAJ
description Background and purpose. Risk of acute ischemic stroke has been associated with carotid artery atherosclerosis as well as with periodontal disease. We studied whether oral pathology or carotid atherosclerosis was associated with the presence and quantity of bacterial DNA in their aspirated thrombi. Methods. Thrombus aspirates and control arterial blood were taken from 71 patients (70.4% male; mean age, 67.4 years) with acute ischemic stroke. Tooth pathology was registered using CT scans. Carotid stenosis was estimated with CTA and ultrasonography. The presence of bacterial DNA from aspirated thrombi was determined using quantitative PCR. We also analyzed the presence of these bacterial DNAs in carotid endarterectomies from patients with peripheral arterial disease. Results. Bacterial DNA was found in 59 (83.1%) of the thrombus aspirates (median, 8.6-fold). Oral streptococcal DNA was found in 56 (78.9%) of the thrombus aspirates (median, 5.1-fold). DNA from A. actinomycetemcomitans and P. gingivalis was not found. Most patients suffered from poor oral health and had in median 19.0 teeth left. Paradoxically, patients with better oral health had more oral streptococcal DNA in their thrombus than the group with the worst pathology (p=0.028). There was a trend (OR 7.122; p=0.083) in the association of ≥50% carotid artery stenosis with more severe dental pathology. Oral streptococcal DNA was detected in 2/6 of carotid endarterectomies. Conclusions. Stroke patients had poor oral health which tended to associate with their carotid artery stenosis. Although oral streptococcal DNA was found in thrombus aspirates and carotid endarterectomy samples, the amount of oral streptococcal DNA in thrombus aspirates was the lowest among those with the most severe oral pathology. These results suggest that the association between poor oral health and acute ischemic stroke is linked to carotid artery atherosclerosis.
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spelling doaj-art-4eac6de26b244b7ebcb36e1e86efe3162025-08-20T03:36:34ZengWileyStroke Research and Treatment2090-81052042-00562021-01-01202110.1155/2021/54027645402764Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with StrokeOlli Patrakka0Helena Mehtonen1Sari Tuomisto2Juha-Pekka Pienimäki3Jyrki Ollikainen4Heini Huhtala5Tanja Pessi6Niku Oksala7Terho Lehtimäki8Jorma Järnstedt9Mika Martiskainen10Pekka J. Karhunen11Department of Forensic Medicine, Faculty of Medicine and Health Technology, Tampere University and Fimlab Laboratories, Tampere, FinlandMedical Imaging Center, Department of Radiology, Tampere University Hospital, Tampere, FinlandDepartment of Forensic Medicine, Faculty of Medicine and Health Technology, Tampere University and Fimlab Laboratories, Tampere, FinlandVascular Centre, Tampere University Hospital, Tampere, FinlandDepartment of Neurology, Tampere University Hospital, Tampere, FinlandFaculty of Social Sciences, Tampere University, Tampere, FinlandHemorrhagic Brain Pathology Research Group, Tampere University, Tampere, FinlandVascular Centre, Tampere University Hospital, Tampere, FinlandDepartment of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Fimlab Laboratories and Finnish Cardiovascular Research Center Tampere, Tampere, FinlandMedical Imaging Center, Department of Radiology, Tampere University Hospital, Tampere, FinlandDepartment of Forensic Medicine, Faculty of Medicine and Health Technology, Tampere University and Fimlab Laboratories, Tampere, FinlandDepartment of Forensic Medicine, Faculty of Medicine and Health Technology, Tampere University and Fimlab Laboratories, Tampere, FinlandBackground and purpose. Risk of acute ischemic stroke has been associated with carotid artery atherosclerosis as well as with periodontal disease. We studied whether oral pathology or carotid atherosclerosis was associated with the presence and quantity of bacterial DNA in their aspirated thrombi. Methods. Thrombus aspirates and control arterial blood were taken from 71 patients (70.4% male; mean age, 67.4 years) with acute ischemic stroke. Tooth pathology was registered using CT scans. Carotid stenosis was estimated with CTA and ultrasonography. The presence of bacterial DNA from aspirated thrombi was determined using quantitative PCR. We also analyzed the presence of these bacterial DNAs in carotid endarterectomies from patients with peripheral arterial disease. Results. Bacterial DNA was found in 59 (83.1%) of the thrombus aspirates (median, 8.6-fold). Oral streptococcal DNA was found in 56 (78.9%) of the thrombus aspirates (median, 5.1-fold). DNA from A. actinomycetemcomitans and P. gingivalis was not found. Most patients suffered from poor oral health and had in median 19.0 teeth left. Paradoxically, patients with better oral health had more oral streptococcal DNA in their thrombus than the group with the worst pathology (p=0.028). There was a trend (OR 7.122; p=0.083) in the association of ≥50% carotid artery stenosis with more severe dental pathology. Oral streptococcal DNA was detected in 2/6 of carotid endarterectomies. Conclusions. Stroke patients had poor oral health which tended to associate with their carotid artery stenosis. Although oral streptococcal DNA was found in thrombus aspirates and carotid endarterectomy samples, the amount of oral streptococcal DNA in thrombus aspirates was the lowest among those with the most severe oral pathology. These results suggest that the association between poor oral health and acute ischemic stroke is linked to carotid artery atherosclerosis.http://dx.doi.org/10.1155/2021/5402764
spellingShingle Olli Patrakka
Helena Mehtonen
Sari Tuomisto
Juha-Pekka Pienimäki
Jyrki Ollikainen
Heini Huhtala
Tanja Pessi
Niku Oksala
Terho Lehtimäki
Jorma Järnstedt
Mika Martiskainen
Pekka J. Karhunen
Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke
Stroke Research and Treatment
title Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke
title_full Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke
title_fullStr Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke
title_full_unstemmed Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke
title_short Association between Oral Pathology, Carotid Stenosis, and Oral Bacterial DNA in Cerebral Thrombi of Patients with Stroke
title_sort association between oral pathology carotid stenosis and oral bacterial dna in cerebral thrombi of patients with stroke
url http://dx.doi.org/10.1155/2021/5402764
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