ABSTRACT
Background: Acute coronary syndrome (ACS) is a leading cause of death, with significant disparities in risk factors and outcomes. The relationship between periodontal disease (PD), periostin (PN), and cardiovascular disease is complex, with both conditions sharing inflammatory pathways and risk factors. This study investigates the link between PN serum levels and cardiovascular risk factors in patients with ACS and concomitant PD. Methods: This case–control study involved 92 patients with ACS and PD admitted to the County Emergency Clinical Hospital of Târgu Mureș, Romania. Patients were divided into low PN (LP) and high PN (HP) groups based on a median PN level of 30.63 ng/ml. Clinical data, lipid profiles, and biomarkers were compared between groups. Results: Patients in the LP group had significantly higher total HDL cholesterol and triglyceride levels, and significantly lower LDL cholesterol levels compared to the HP group. Linear regression analysis showed a positive correlation between serum PN and LDL cholesterol (p < 0.0001) and a negative correlation between PN and HDL cholesterol (p < 0.0001). There were no statistically significant differences in apolipoprotein B, serum uric acid, creatinine, or blood glucose levels between the groups. However, patients in the HP group had a significantly higher prevalence of ST-elevation myocardial infarction (p < 0.05). Conclusion: In patients with ACS and PD, PN levels correlate with lipid profiles, particularly LDL and HDL cholesterol, and are associated with the type of myocardial infarction. These findings suggest PN may play a role in the complex interplay between PD, ACS, and cardiovascular risk, warranting further research to clarify its potential as a biomarker.