Background: An association between periodontitis and cardiovascular diseases has been suggested. Aims: to study if a combination of clinical variables in a functional risk diagram enhanced the ability to differentiate between subjects with or without an immediate history of acute myocardial infarction (AM). Material and methods: A functional periodontal pentagon risk diagram (PPRD) with five periodontal risk vectors was created and the surface of individual PPRDs was calculated using data from 88 subjects with recent AMI and 80 matched control subjects with no history of AMI. Results: Age, gender, remaining teeth (mean value: 21.1 versus 21.6 teeth) smoking status and pocket probing depth (PPD) distribution did not differ by AMI status. Gingival recession was significantly greater in controls (mean difference: 5.7, S.D. + 1.9, p<0.01, 95% CI: 1.8 to 9.6). Only PPRD scores were associated with AMI status when factors not included in the PPRD were studied (â= 22.1, S.E. 5.9, p<0.0001, 95% CI: 10.3 to 33.7). ROC curve analysis suggested that for AMI differentiation the best individual predictive periodontal parameters was the > 50% bone loss (> 4.0 mm) (area under curve: 0.79, p<0.001, 95% CI: 0.72 to 0.87). The best association between AMI status and study variables were the combination of > 4 mm of bone loss at + 50%, % BOP, %PPDs > 6 mm, and tooth loss (Nagelkirke r2 = 0.46). Conclusions: The combination of five periodontal parameters in a periodontal pentagon risk diagram added predictive value suggesting that comprehensive data should be used in studies of associations between periodontitis and heart diseases. Supported by Region Skane, Sweden

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