<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1409-4142</journal-id>
<journal-title><![CDATA[Revista Costarricense de Cardiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. costarric. cardiol]]></abbrev-journal-title>
<issn>1409-4142</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Cardiología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-41422018000400037</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Relación entre la enfermedad Periodontal y enfermedad cardiovascular. La necesidad de un protocolo de manejo]]></article-title>
<article-title xml:lang="en"><![CDATA[Relationship between Periodontal disease and cardiovascular disease. The need for a management protocol]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quesada-Chaves]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital San Vicente de Paúl  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>20</volume>
<numero>2</numero>
<fpage>37</fpage>
<lpage>43</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-41422018000400037&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-41422018000400037&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-41422018000400037&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La enfermedad periodontal y la enfermedad cardiovascular son dos de las enfermedades más prevalentes en la población mundial. Son ambas enfermedades de alto impacto en la salud pública. La enfermedad periodontal se define como una inflamación crónica de los tejidos que dan soporte a los dientes causada por bacterias bacilos gram negativos y espiro quetas que se generan en biofilms alrededor de los dientes. La prevalencia de la periodontitis severa va desde el 1% en pacientes entre 20 y 29 años hasta de 39% en pacientes mayores de 65 años. La presencia de microorganismos genera una respuesta inflamatoria local y sistémica. La producción de reactantes de fase aguda y mediadores proinflamatorios aumenta el riesgo de inflamación en las placas ateroescleróticas haciéndolas propensas a ruptura. Existe además lo posibilidad de la entrada de bacterias al torrente sanguíneo, dichas bacteremias se han relacionado con la posibilidad de endocarditis infecciosa. Estudios epidemiológicos han demostrado un aumento del riesgo de enfermedad cardiovascular en pacientes con enfermedad periodontal activa, independientemente de otros factores de riesgo que comparten ambas patologías. El riesgo relativo varía entre diferentes autores y trabajos realizados pero está cercano al 19% como lo demostró Wei-Dong en su metanalisis. El efecto de la periodontitis se ha evidenciado en otros aspectos del espectro clínico de la enfermedad cardiovascular como lo son la alteración de la actividad insulínica, glicogénesis hepática y alteración de la microflora intestinal que lleva a procesos de inflamación sistémica y cambios metabólicos. Por estas razones es aconsejable realizar una revisión exhaustiva de la condición dental de los pacientes en riesgo de enfermedad cardiovascular. En aquellos con datos de enfermedad activa se aconseja la extracción y reparación de piezas dentales. El uso de clorhexidina es aconsejable como parte del tratamiento de la enfermedad así como la prevención de la misma en pacientes de riesgo o que vayan a ser sometidos a procedimientos quirúrgicos. En casos especiales se aconseja profilaxis antibiótica para prevenir la endocarditis infecciosa.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Relationship between Periodontal disease and cardiovascular disease. The need for a management protocol Periodontal disease and cardiovascular disease are two of the most prevalent diseases in the world population. Both diseases have high impact on public health. Periodontal disease is defined as a chronic inflammation of the tissues that support the teeth caused by gram-negative bacilli bacteria and spirochetes that are generated in biofilms around the teeth. The prevalence of severe periodontitis ranges from 1% in patients between 20 and 29 years old to 39% in patients older than 65 years. The presence of microorganisms generates a local and systemic inflammatory response. The production of acute phase reactants and proinflammatory mediators increases the risk of inflammation in atherosclerotic plaques making them prone to rupture. There is also the possibility of entrance of bacteria into the bloodstream and bacteremias have been linked to the possibility of infective endocarditis. Epidemiological studies have shown an increased risk of cardiovascular disease in patients with active periodontal disease, independently of other risk factors that share both pathologies. The relative risk varies between different authors and works performed but is close to 19% as demonstrated by Wei-Dong in his meta-analysis. The effect of periodontitis has been evidenced in other aspects of the clinical spectrum of cardiovascular disease such as the alteration of insulin activity, hepatic glycogenesis and alteration of the intestinal microflora that leads to processes of systemic inflammation and metabolic changes. For these reasons it is advisable to carry out a comprehensive review of the dental condition of patients at risk for cardiovascular disease. In those with active disease data suggest it is appropriate to remove and repair dental pieces. The use of chlorhexidine is advisable as part of the treatment of the periodontal disease as well as the prevention in patients at risk or who will undergo surgical procedures. In special cases antibiotic prophylaxis is recommended to prevent infective endocarditis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[enfermedad periodontal]]></kwd>
<kwd lng="es"><![CDATA[enfermedad cardiovascular]]></kwd>
<kwd lng="es"><![CDATA[profilaxis]]></kwd>
<kwd lng="es"><![CDATA[endocarditis bacteriana]]></kwd>
<kwd lng="es"><![CDATA[ateroesclerosis]]></kwd>
<kwd lng="en"><![CDATA[periodontal disease]]></kwd>
<kwd lng="en"><![CDATA[cardiovascular disease]]></kwd>
<kwd lng="en"><![CDATA[prophylaxis]]></kwd>
<kwd lng="en"><![CDATA[infective endocarditis]]></kwd>
<kwd lng="en"><![CDATA[atherosclerosis]]></kwd>
</kwd-group>
</article-meta>
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<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<source><![CDATA[2015 ESC Guidelines for the Management of Infective Endocarditis]]></source>
<year>2015</year>
<volume>36</volume>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
