Periodontal disease and cardiovascular events: mechanisms, biomarkers, and clinical translation.

This review integrates epidemiological, mechanistic and clinical evidence demonstrating that patients with periodontitis carry higher risks of cardiovascular events than healthy individuals. Literature from major databases was analyzed narratively. Findings indicate higher risks of myocardial infarction, stroke, and atrial fibrillation driven by systemic inflammation, endothelial dysfunction, vascular invasion, oral-gut-vascular, and epigenetic pathways. Biomarkers show diagnostic potential, while therapy improves surrogate outcomes but not hard endpoints. The review integrates evidence to inform risk stratification and prevention strategies.