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Estrogen Receptor Polymorphisms and the Risk of Myocardial Infarction

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To the Editor: Dr Schuit and colleagues¹ demonstrated a significant association between estrogen receptor gene (ESR1) polymorphisms and increased risk of myocardial infarction (MI) in postmenopausal women but not in men. Since Mattila et al² first found an association between poor oral health and risk of MI in men, several studies have found such an association in women as well.³ We have reported a significant association between ESR1 polymorphisms and tooth loss in postmenopausal women.⁴

These facts suggest 3 possible hypotheses explaining the link described by Schuit et al: (1) the oral infection-inflammation pathway mediated by periodontitis, one of the major causes of tooth loss, contributes to increased risk of MI,⁵ so that the association between ESR1 polymorphisms and MI in postmenopausal women is spurious and actually due to an association between ESR1 polymorphisms and tooth loss at baseline; (2) endothelial dysfunction that may lead to MI contributes . . . [Full Text of this Article]

Akira Taguchi, DDS, PhD
akiro@hiroshima-u.ac.jp
Department of Oral and Maxillofacial Radiology
Hiroshima University Hospital
Hiroshima, Japan

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