ASSOCIATION BETWEEN ACUTE CEREBROVASCULAR ISCHEMIA AND CHRONIC AND RECURRENT INFECTION

Background and Purpose We performed a case-control study to investigat e whether chronic or recurrent respiratory, ear-nose-throat (ENT), and dental infections are risk factors for cerebrovascular ischemia. Meth ods Using a standardized questionnaire we investigated past infectious diseases in 166 consecutive patients with acute cerebrovascular ische mia and in 166 age- and sex-matched nonstroke neurological patient con trols. In subgroups, we performed standardized ENT (69 patients, 66 co ntrol subjects) and dental examinations including orthopantomography ( 66 patients, 60 control subjects). Dental status was determined by a t otal dental index (TDI) that reflects caries, periapical lesions, peri odontitis, and other dental lesions and by an orthopantomography index (OPGI) that was assessed blinded. Results Frequent (greater than or e qual to 2 episodes in each of the 2 preceding years) or chronic bronch itis was associated with cerebrovascular ischemia in age-adjusted mult iple logistic regression analysis (odds ratio: OR, 2.2; 95% confidence interval, CI, 1.04 to 4.6). Groups were not different in ENT examinat ion. Patients tended to have a worse dental status (TDI: P=.070; OPGI: P=.062) and had more severe periodontitis (P=.047) and periapical les ions (P=.027) than control subjects. In age adjusted multiple logistic regression analysis with social status and established vascular risk factors, poor dental status (TDI) was independently associated with ce rebrovascular ischemia (OR, 2.6; 95% CI, 1.18 to 5.7). Conclusion Recu rrent or chronic bronchial infection and poor dental status, mainly re sulting from chronic dental infection, may be associated with an incre ased risk for cerebrovascular ischemia.