OBJECTIVE: To investigate whether there is a relationship between active periodontal disease (PD) and acute coronary syndromes (ACS). METHODS: Three hundred and sixty-one patients (57,3% male), ages ranging from 27 to 89 (mean ± DP = 60.5 ± 12.2), were admitted to the Intensive Care Unit of a Teaching Hospital with symptoms and complementary examinations consistent with acute coronary syndrome. All the patients had a complete periodontal examination in the ICU setting, and 325 (90.9%) underwent coronary angiography for diagnostic confirmation and/or treatment planning. Periodontal examination included evaluation of all the teeth in the oral cavity and the following parameters: probing depth, clinical attachment level, plaque index, and gingival index. RESULTS: Of the 325 patients, 91 (28%) had coronary arteries free of obstruction or with mild obstructions (< 50% diameter stenosis), and the remaining 72% had severe obstructions. Fisher's exact text yielded a p value of 0.0245 with an odds ratio of 2.571 (95% CI 1.192 to 5.547), meaning that the group with ACS and significant obstructive coronary artery disease was 2.5-fold more likely to have active PD. CONCLUSION: A significant association was found between active periodontal disease and severe obstructive coronary artery in patients with acute coronary syndrome, underscoring the importance of prevention and adequate treatment of periodontal disease, which should be considered as a potential risk factor in the etiology and instability of the atherosclerotic plaque.

OBJECTIVE: To correlate values of rate-pressure product (RPP) above 30,000 mmHg.bpm with or without significant obstructive coronary artery disease (CAD) in patients with positive exercise test. METHODS: A retrospective analysus of 246 patients that had been submitted to Exercise Treadmill Test (ETT) up to 30 days before coronary angiography on suspicion of obstructive disease. The 165 patients in which the ETT was positive were analyzed considering as positive the presence of horizontal or descending depression of the ST segment for at least 1 mm, 0.08 seconds after J point. RESULTS: Among the 165 appraised patients, 50 (30.3%) reached RPP > 30,000 mmHg.bpm, of which 38 (76%) had normal coronary vessel angiography or low degree obstructive coronary artery disease and 12 (24%) had significant. Among the remaining 115 appraised patients with positive ETT and RPP < 30,000 mmHg.bpm, 59 (51.3%) were normal or with low significance obstructive coronary artery disease, and 56 (48.7%) had significant disease. (Odds Ratio = 0.3327 CI 95% = 0.1579 to 0.7009; P=0.0034). CONCLUSION: Based on data collected in the present investigation, it has been demonstrated that RPP above 30,000 mmHg.bpm stands as a relevant variable to predict the absence of significant obstructive coronariopathy in individuals with positive ET and as a useful tool in making clinical decisions.