Could hidden dental bacteria help explain sudden and deadly heart attacks?, Pg9

Key Highlights:

• A study in the Journal of the American Heart Association found that viridans streptococci, common oral bacteria, can form biofilms inside atherosclerotic plaques.
• The bacteria remain hidden from the immune system and may contribute to fatal heart attacks.
• Researchers examined coronary arteries from 121 sudden-death autopsies and 96 patients undergoing vascular surgery.
• Viridans streptococci were present in about 42% of both autopsy and surgical cases.

Detailed Insights:

• Coronary artery disease is driven by cholesterol deposition, high blood pressure, diabetes, and smoking, all of which promote chronic inflammation in the arteries.
• Researchers have proposed infection-related inflammation as a trigger for plaque rupture, leading to heart attacks.
• The bacteria form biofilms within the lipid-rich cores of plaques, where immune cells largely fail to notice them, suggesting they could persist silently for years.
• In ruptured plaques, the bacteria had shifted location into the outer layer that covers the plaque and prevents it from spilling into the bloodstream.
• Attempts to treat coronary disease with antibiotics have repeatedly failed in large clinical trials, and biofilms may explain why.
• Regular dental care was associated with a 23% lower stroke risk, while more frequent tooth brushing linked to reduced cardiovascular events.
• Untreated periodontal disease, apical periodontitis and chronic dental infections correlate with higher risks of stroke and coronary disease.
• Oral swab surveillance after the age of 40 could be one way to test the biofilm-heart link in community settings, if validated by further research.

Key Concepts Involved:

• Atherosclerotic plaques: Buildups of fat, cholesterol, and other substances in the artery walls.
• Biofilms: A thin, slimy film of bacteria that adheres to a surface.
• Viridans streptococci: A group of common oral bacteria.
• Coronary artery disease: A condition in which the coronary arteries become narrowed or blocked.