Periodontal Disease and Risk of Atrial Fibrillation and Atrial Flutter: A Meta-Analysis

Purpose: Poor oral hygiene can provoke transient bacteremia, systemic inflammation, and subsequent major cardiovascular diseases including coronary disease and stroke. Periodontal disease is one of the most common systemic inflammatory diseases worldwide. The data regarding the association between periodontal disease and atrial fibrillation or atrial flutter is limited. We, therefore, conducted a meta-analysis to evaluate the risk of atrial fibrillation and atrial flutter in periodontal disease patients.

Material and Methods: We independently searched the databases of MEDLINE and EMBASE from the inception to December 13, 2022. We included cohort studies that evaluate the risk of atrial fibrillation or atrial flutter in periodontal disease patients. Data from each study were combined using the random-effects model to calculate pooled odds ratio (OR) with 95% confidence interval (CI).

Results: A total of four eligible cohort studies involving 680,641 patients with periodontal disease and 378,154 patients without periodontal disease were included in our meta-analysis. We found that patients with periodontal disease have a significantly higher risk of atrial fibrillation and atrial flutter compared to patients who do not have periodontal disease with the pooled OR of 1.331 (95% CI 1.250-1.418; p< 0.001, I2=50.2%).

Conclusions: Our meta-analysis indicated that periodontal disease is associated with a higher risk of atrial fibrillation and atrial flutter. Further studies are required to confirm the result and investigate how this should be addressed in clinical practice.