Effectiveness of Periodontitis Treatment on the Metabolic Activity of Symptomatic Carotid Atherosclerotic Plaque Responsible for Ischemic Stroke (PerioStroke)

Assistance Publique - Hôpitaux de Paris

Status

Not yet enrolling

Conditions

Ischemic Stroke

Severe Periodontitis

Treatments

Procedure: periodontal treatment strategy

Study type

Interventional

Funder types

Other

Identifiers

NCT06484036

APHP230861

Details and patient eligibility

About

Cardiovascular disease is the world's leading cause of death. Atherothrombosis is a common cause of ischemic stroke.

A strong epidemiological link has been established between periodontitis and the risk of stroke. It shares common risk factors with atherothrombosis, and its severe form is associated with low-grade systemic inflammation and daily low-intensity bacteremia. Atherothrombosis is a frequent cause of ischemic stroke.

Periodontal bacteria have been found within atheromatous plaques, correlated with a greater risk of rupture.

Thus, periodontitis could be a modifiable risk factor for atherothrombosis and future vascular events: its early diagnosis and treatment could have a major impact on cardiovascular prevention.

Hypothesis: In patients with periodontitis who have had an ischemic stroke, periodontal treatment may reduce atherosclerotic plaque activity.

Enrollment

157 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age ≥ 18 years
Minor ischemic stroke of the anterior circulation (NIHSS ≤ 5) of atherothrombotic origin according to the TOAST scale <30 days
Atheroma plaque of the ipsilateral carotid bulb >30% not eligible for intervention (endarterectomy or angioplasty-stenting)
Severe periodontitis (stage 3 or 4)
Signed informed consent
Affiliation to a social security scheme

Exclusion criteria

< 6 teeth
Without independent oral hygiene
Contraindications to PET scan
Known allergy to fluoro-deoxyglucose and its excipient
Immunosuppressive treatment
Uncontrolled diabetes
High risk of infective endocarditis
Organ transplant pending
Progressive infectious diseases
Active smoking not stopped
Patient deprived of liberty by judicial or administrative decision
Patient under legal protection (guardianship, curatorship)
Participation in another interventional research involving humans or being in the exclusion period following previous research involving humans
Pregnant or breastfeeding woman Patient under AME (state medical aid)