Objective.We sought to evaluate any association of periodontitis in patients with angina despite non-obstructive coronary artery disease (CAD).Methods.Electronic records of all patients (n=103,955) labeled as ACS were screened and the patients diagnosed with myocardial infarction with non-obstructive coronary arteries (MINOCA) were enrolled as group 1 and age-matched controls with no CAD were labeled as group 2.Results.Female gender (OR (95%CI): 1.04 (0.93 -1.59); p=0.004), diabetes mellitus (OR (95%CI): 0.25 (0.05-0.63); p=0.02), peripheral arterial disease (OR (95%CI): 0.78 (0.63 -0.91); p=0.001), dyslipidemia (OR (95%CI): 1.45 (0.47 -2.93); p=0.015), smoking, moderate (OR (95%CI): 5.42 (1.91 -22.69); p=0.04) and severe periodontitis (OR (95%CI): 2.58 (1.72 -3.26); p=0.027) were independent predictors of MINOCA.There was an increased graded risk (relative risk (RR)) of MINOCA with periodontitis + diabetes mellitus (RR (95%CI): 0.91 (0.34 -1.23); p=0.032), periodontitis + peripheral arterial disease (RR (95%CI): 0.85 (0.47 -1.46); p=0.025), periodontitis + renal disease (RR (95%CI): 1.04 (0.85 -1.23); p=0.04), and periodontitis + smoking (RR (95%CI): 0.94 (0.77 -1.06); p=0.006).