The investigators performed a randomized controlled trial with investigator-masked design enrolling subjects with acute myocardial infarction.

The purpose of this study is to find a treatment strategy to reduce the risk of recurrence of myocardial infarction through oral hygiene improvement.

Subjects were divided into a treatment group and a control group. Both sides receive basic periodontal examinations, but the treatment group receives active dental procedure such as scaling and root planing. Both groups also receive post-myocardial infarction management.

As part of a pilot study, this study used the primary outcome measure for changes in surrogate markers rather than clinical outcomes.

Inclusion Criteria:

• Adults over 18
• Patients diagnosed with type 1 or 2 MI according to the Fourth Universal Definition of Myocardial Infarction (2018) criteria
• Patients with baseline hsCRP (high-sensitivity C-reactive protein) elevated above 1.0 mg / dL

Exclusion Criteria:

1. clinical exclusion criteria

   • Inability to provide informed consent
   • Patients who are predicted to have low compliance
   • Those whose life expectancy is less than 3 months due to cardiovascular disease or other reasons
   • Those who are considered to be too poor condition to perform dental treatment or have a high risk of bleeding
   • Those who need active dental treatment such as extraction
   • Patients suspected of having active infection
   • Those who are taking long-term systemic antibiotics or receiving immunosuppressive treatment

2. periodontal exclusion criteria

   • Fully edentulous (Except for fixed implant restorations)
   • If more than 15 teeth and implants do not exist
   • If the last dental visit experience is less than 6 months
   • If periodontal treatment is not possible by the researcher

Participating patients and dentists are not able to blind information about random allocation. However, in order to reduce the bias, the cardiologist who treats the patient and prescribes the medicines performs an investigator-masked design that masks information about the treatment group.