This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Purpose: A longitudinal cohort study to determine and quantify the independent contribution of periodontal infections and host inflammatory response to the risk of aortic plaque progression and the associated recurrence of vascular events .Participants: 110 consecutive stroke/TIA patients who had transesophageal (TEE) assessment of aortic arch atheroma.Procedures (methods): 110 consecutive stroke/TIA patients will be subjected to a protocol mandated sequential transesophageal (TEE) assessment of aortic arch atheroma (aortic AA). At baseline,subjects will undergo assessments for traditional vascular risk factors (example: lipidprofile, BMI, homocysteine, glucose, EKG, ABI and echocardiography) as a part of standard clinical care. Data from such assessments when available will be collected for the purpose of this study. Additionally as a part of the study subjects will undergo a comprehensive periodontal examination assessing clinical, microbiologic sample (banked for future species DNA-DNA hybridization),immunologic (species-specific antibodies to periodontal pathogens) and inflammatory response (serum hs-CRP, IL-6, s-ICAM and 8-isoprostane) markers. TEE measurements of AA will be conducted at baseline and at 1-year follow up to assess progression. They will also undergo assessment of recurrent vascular events over 5 years. The concurrent measures of local as well as systemic markers of infection and inflammation should help determine whether the infection or the inflammation component of periodontal disease better explains the purported association withatherosclerosis and secondary stroke/TIA.
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