المؤلفون: Marjo Okkonen, Aki S. Havulinna, Olavi Ukkola, Heikki Huikuri, Arto Pietilä, Heli Koukkunen, Seppo Lehto, Juha Mustonen, Matti Ketonen, Juhani Airaksinen, Y. Antero Kesäniemi, Veikko Salomaa

المصدر: Annals of Medicine, Vol 53, Iss 1, Pp 817-823 (2021)

مصطلحات موضوعية: Epidemiology, acute coronary syndromes, prevention, major adverse cardiac event, Medicine

الوصف: AbstractAims To evaluate risk factors for major adverse cardiac event (MACE) after the first acute coronary syndrome (ACS) and to examine the prevalence of risk factors in post-ACS patients.Methods We used Finnish population-based myocardial infarction register, FINAMI, data from years 1993–2011 to identify survivors of first ACS (n = 12686), who were then followed up for recurrent events and all-cause mortality for three years. Finnish FINRISK risk factor surveys were used to determine the prevalence of risk factors (smoking, hyperlipidaemia, diabetes and blood pressure) in post-ACS patients (n = 199).Results Of the first ACS survivors, 48.4% had MACE within three years of their primary event, 17.0% were fatal. Diabetes (p = 4.4 × 10−7), heart failure (HF) during the first ACS attack hospitalization (p = 6.8 × 10−15), higher Charlson index (p = 1.56 × 10−19) and older age (p = .026) were associated with elevated risk for MACE in the three-year follow-up, and revascularization (p = .0036) was associated with reduced risk. Risk factor analyses showed that 23% of ACS survivors continued smoking and cholesterol levels were still high (>5mmol/l) in 24% although 86% of the patients were taking lipid lowering medication.Conclusion Diabetes, higher Charlson index and HF are the most important risk factors of MACE after the first ACS. Cardiovascular risk factor levels were still high among survivors of first ACS.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/0785-3890Test; https://doaj.org/toc/1365-2060Test

الوصول الحر: https://doaj.org/article/3ad2098ef9ae467e890a88e845d30d3aTest

المؤلفون: Billy Mushi, Sajal Kabiraj, Juha Mustonen

المصدر: Management Dynamics. 22:52-60

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::89d63ca0ad506a3f839925ae8fe258ffTest
https://doi.org/10.57198/2583-4932.1301Test

المؤلفون: Teppo Repo, Markku Tykkyläinen, Juha Mustonen, Tuomas Rissanen, Matti Ketonen, Maija Toivakka, Tiina Laatikainen

المصدر: International Journal of Environmental Research and Public Health; Volume 15; Issue 4; Pages: 724

مصطلحات موضوعية: secondary prevention, electronic medical records, coronary heart disease, primary care, quality of care, rural health, risk factors of CHD, geospatial health, health-care planning

جغرافية الموضوع: agris

الوصف: Despite comprehensive national treatment guidelines, goals for secondary prevention of coronary heart disease (CHD) have not been sufficiently met everywhere in Finland. We investigated the recorded risk factor rates of CHD and their spatial differences in North Karelia Hospital District, which has a very high cardiovascular burden, in order to form a general view of the state of secondary prevention in a high-risk region. Appropriate disease codes of CHD-diagnoses and coding for percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) were used to identify from the electronic patient records the patient group eligible for secondary prevention. The cumulative incidence rate of new patients (n = 2556) during 2011–2014 varied from 1.9% to 3.5% between municipalities. The success in secondary prevention of CHD was assessed using achievement of treatment targets as defined in national guidelines. Health centres are administrated by municipalities whereupon the main reporting units were municipalities, together with composed classification of patients by age, gender and dwelling location. Health disparities between municipalities, settlement types and patient groups were found and are interpreted. Moreover, spatial high-risk and low-risk clusters of acute CHD were detected. The proportion of patients achieving the treatment targets of low-density lipoprotein cholesterol (LDL-C) varied from 21% to 38% between municipalities. Variation was also observed in the follow-up of patients; e.g., the rate of follow-up measurements of LDL-C in municipalities varied from 72% to 86%. Spatial variation in patients’ sociodemographic and neighbourhood characteristics and morbidity burden partly explain the differences in outcomes, but there are also very likely differences in the care process between municipalities which requires a study in its own right.

وصف الملف: application/pdf

العلاقة: https://dx.doi.org/10.3390/ijerph15040724Test

الإتاحة: https://doi.org/10.3390/ijerph15040724Test

المؤلفون: Y. Antero Kesäniemi, Heli Koukkunen, Olavi Ukkola, Matti Ketonen, Juhani Airaksinen, Marjo Okkonen, Veikko Salomaa, Seppo Lehto, Arto Pietilä, Heikki V. Huikuri, Aki S. Havulinna, Juha Mustonen

المساهمون: Medicum, Institute for Molecular Medicine Finland, Complex Disease Genetics

المصدر: Annals of Medicine
article-version (VoR) Version of Record

مصطلحات موضوعية: Cardiovascular event, ACUTE MYOCARDIAL-INFARCTION, medicine.medical_specialty, Acute coronary syndrome, PROGNOSIS, Heart disease, Epidemiology, Myocardial Infarction, HEART-DISEASE, HOSPITAL DISCHARGE REGISTER, 030204 cardiovascular system & hematology, Risk Assessment, MORBIDITY, 03 medical and health sciences, 0302 clinical medicine, prevention, Risk Factors, Internal medicine, Diabetes Mellitus, medicine, Humans, acute coronary syndromes, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Acute Coronary Syndrome, VALIDITY, PREDICTORS, Aged, Heart Failure, business.industry, MORTALITY, General Medicine, medicine.disease, PREVENTION, EUROPEAN-SOCIETY, 3. Good health, major adverse cardiac event, 3121 General medicine, internal medicine and other clinical medicine, Cardiology, Cardiology & Cardiovascular Disorders, business, Mace, Research Article

الوصف: Aims: To evaluate risk factors for major adverse cardiac event (MACE) after the first acute coronary syndrome (ACS) and to examine the prevalence of risk factors in post-ACS patients. Methods: We used Finnish population-based myocardial infarction register, FINAMI, data from years 1993–2011 to identify survivors of first ACS (n = 12686), who were then followed up for recurrent events and all-cause mortality for three years. Finnish FINRISK risk factor surveys were used to determine the prevalence of risk factors (smoking, hyperlipidaemia, diabetes and blood pressure) in post-ACS patients (n = 199). Results: Of the first ACS survivors, 48.4% had MACE within three years of their primary event, 17.0% were fatal. Diabetes (p = 4.4 × 10−7), heart failure (HF) during the first ACS attack hospitalization (p = 6.8 × 10−15), higher Charlson index (p = 1.56 × 10−19) and older age (p = .026) were associated with elevated risk for MACE in the three-year follow-up, and revascularization (p = .0036) was associated with reduced risk. Risk factor analyses showed that 23% of ACS survivors continued smoking and cholesterol levels were still high (>5mmol/l) in 24% although 86% of the patients were taking lipid lowering medication. Conclusion: Diabetes, higher Charlson index and HF are the most important risk factors of MACE after the first ACS. Cardiovascular risk factor levels were still high among survivors of first ACS.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d1851c5b740ed5347a17df8ea9714692Test
https://doi.org/10.1080/07853890.2021.1924395Test

المؤلفون: Veikko Salomaa, Juha Mustonen, Juhani Airaksinen, Marjo Okkonen, Matti Ketonen, Y. Antero Kesäniemi, Heikki V. Huikuri, Aki S. Havulinna, Olavi Ukkola

المصدر: Scandinavian Cardiovascular Journal. 54:108-114

مصطلحات موضوعية: medicine.medical_specialty, business.industry, ST elevation, 030204 cardiovascular system & hematology, medicine.disease, Coronary heart disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Register data, St elevation myocardial infarction, Internal medicine, cardiovascular system, Hospital discharge, medicine, Cardiology, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Cardiology and Cardiovascular Medicine, business

الوصف: Objectives. To examine the validity of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) diagnoses in Finnish nation-wide hospital discharge register (H...

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::76de3eabd69122cb13aa98a9f480bf9aTest
https://doi.org/10.1080/14017431.2019.1686165Test

المؤلفون: Helena Kervinen, Paavo Uusimaa, Juhani Junttila, Tiina Heliö, Mari Niemi, Joose Raivo, Maija Kaartinen, John Melin, Ilkka Mahonen, Markku Laakso, Johanna Kuusisto, Liisa Hämäläinen, Heini Jyrkila, Matti Kotila, Paula Vartia, Markku S. Nieminen, Erkki Ilveskoski, Mikko Pietilä, Teemu Kuulasmaa, Jukka Juvonen, Pertti Jääskeläinen, FinHCM Study Grp, Jagadish Vangipurapu, Juha Mustonen, Sari U. M. Vanninen, Jorma Kokkonen, Katriina Aalto-Setälä

المساهمون: Department of Medicine, Clinicum, Kardiologian yksikkö, HUS Heart and Lung Center

المصدر: ESC Heart Failure

مصطلحات موضوعية: Male, medicine.medical_treatment, DNA Mutational Analysis, ASP175ASN MUTATION, TPM1, 030204 cardiovascular system & hematology, DISEASE, 0302 clinical medicine, FOUNDER MUTATIONS, Original Research Articles, MAGNETIC-RESONANCE, Original Research Article, Registries, 030212 general & internal medicine, Finland, Outcome, education.field_of_study, Hazard ratio, Hypertrophic cardiomyopathy, IMPAIRMENT, Implantable cardioverter-defibrillator, Pedigree, 3. Good health, Survival Rate, INSIGHTS, Targeted sequencing, cardiovascular system, Female, Cardiology and Cardiovascular Medicine, Sarcomeres, Heterozygote, medicine.medical_specialty, Population, 03 medical and health sciences, ALPHA-TROPOMYOSIN, Internal medicine, Genetics, medicine, Humans, cardiovascular diseases, education, business.industry, MORTALITY, Cardiomyopathy, Hypertrophic, medicine.disease, Confidence interval, HEAVY-CHAIN GENE, 3121 General medicine, internal medicine and other clinical medicine, Heart failure, Mutation, MYH7, business, Cardiac Myosins, Follow-Up Studies, Forecasting

الوصف: Aims Nationwide large-scale genetic and outcome studies in cohorts with hypertrophic cardiomyopathy (HCM) have not been previously published. Methods and results We sequenced 59 cardiomyopathy-associated genes in 382 unrelated Finnish patients with HCM and found 24 pathogenic or likely pathogenic mutations in six genes in 38.2% of patients. Most mutations were located in sarcomere genes (MYBPC3, MYH7, TPM1, and MYL2). Previously reported mutations by our study group (MYBPC3-Gln1061Ter, MYH7-Arg1053Gln, and TPM1-Asp175Asn) and a fourth major mutation MYH7-Val606Met accounted for 28.0% of cases. Mutations in GLA and PRKAG2 were found in three patients. Furthermore, we found 49 variants of unknown significance in 31 genes in 20.4% of cases. During a 6.7 +/- 4.2 year follow-up, annual all-cause mortality in 482 index patients and their relatives with HCM was higher than that in the matched Finnish population (1.70 vs. 0.87%; P

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f890b9088a120a8e9c7462ee06ea1f6bTest
https://doi.org/10.1002/ehf2.12420Test

المؤلفون: Matti Ketonen, Y. Antero Kesäniemi, Veikko Salomaa, Seppo Lehto, Juha Mustonen, Olavi Ukkola, Aki S. Havulinna, Heli Koukkunen, Juhani Airaksinen

المصدر: Annals of Medicine. 50(1):1-11

مصطلحات موضوعية: Male, Pediatrics, medicine.medical_specialty, Acute coronary syndrome, Population, Myocardial Infarction, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Case fatality rate, Epidemiology, medicine, Humans, 030212 general & internal medicine, Myocardial infarction, Acute Coronary Syndrome, Mortality, education, Register study, Finland, Aged, Aged, 80 and over, education.field_of_study, business.industry, Incidence (epidemiology), Incidence, General Medicine, ta3121, medicine.disease, Coronary death, Female, business

الوصف: To examine trends in incidence and 28-day case fatality of myocardial infarction (MI) in persons aged 75-99 years in four areas of Finland.The Finnish Acute Myocardial Infarction (FINAMI) register is a population-based MI register study, which during 1995-2012 recorded 30561 suspected acute coronary syndromes in persons aged ≥75 years. Of them, 16229 fulfilled the American Heart Association criteria for a definite, probable or possible MI or coronary death. This age-group contributed 56.8% of all MIs of which 62.7% occurred in women. The incidence of MI decreased by -3.3%/year (95% CI -4.2; -2.4) in women aged 75-84 years, and by -1.2%/year (-1.9; -0.5) in women aged 85-99 years, but among men in these age-groups, only a non-significant reduction occurred. The 28-day case fatality of MI was high. In the age-group 75-84 years, it decreased non-significantly by -1.6%/year in men, and significantly by -2.4%/year (-3.9; -0.8) in women. In the age-group 85-99 years, the decrease was more remarkable: -5.1%/year (-7.8; -2.3) and -3.9%/year (-5.5; -2.2), respectively.In Finland, more than half of MIs occur in the age-group 75-99 years, and most of them in women. The incidence of MI decreased significantly in elderly women but non-significantly in elderly men. The 28-day case fatality decreased especially in the age-group 85-99 years. Key Messages In Finland, more than one half of all myocardial infarctions (MIs) occur in the age-group of 75 years or older. Furthermore, 62.7% of MIs among elderly patients occur among women, although 58.0% of the elderly population are women. The incidence of MI decreased significantly in elderly women but not in elderly men. The 28-day case fatality in elderly patients was high but decreased significantly during the study period 1995-2012. This study provides population-based data on treatment strategies and trends in incidence, event rate, mortality and case fatality of MI in elderly individuals. Elderly patients with acute coronary syndromes still present a remarkable burden to the healthcare system in Finland as well as in many other developed countries. Especially considering the modern trend of reducing hospital resources and shifting patient care to outpatient clinics, the epidemiology of MI in elderly patients remains an important issue for the future planning of the healthcare system.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ed36ebb18a8921d02fdab13d9051d809Test
http://juuli.fi/Record/0283799918Test

المؤلفون: Jussi M Kärkkäinen, Jaakko Eränen, Sanna Uskela, Antti Siljander, Pirjo Mäntylä, Tuomas T. Rissanen, Juha Mustonen M.D.

المصدر: Journal of Interventional Cardiology. 30:139-146

مصطلحات موضوعية: medicine.medical_specialty, Acute coronary syndrome, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, 030204 cardiovascular system & hematology, medicine.disease, Surgery, Atherectomy, 03 medical and health sciences, 0302 clinical medicine, Restenosis, Angioplasty, Conventional PCI, medicine, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, Mace

الوصف: Objectives We investigated the safety and efficacy of PCI using drug-coated balloon (DCB) after rotational atherectomy (rotablation) in a retrospective single center study in patients with calcified de novo coronary lesions. The majority of patients had an increased risk for bleeding. Background DCB has been effective in the treatment of in-stent restenosis, small vessels, and bifurcations. DCB enables short one month dual antiplatelet treatment. No published data exist on the use of DCB after rotablation. Methods 82 PCIs were performed in 65 patients (mean age 72 ± 10 years) using rotablation followed by DCB treatment. The median follow-up time was 17 months. 82% of the patients had at least one risk factor for bleeding such as oral anticoagulation. 32% had an acute coronary syndrome. Median duration of dual antiplatelet treatment was 1 month. Results MACE (the composite of cardiovascular death, ischemia-driven target-lesion revascularization [TLR] or non-fatal myocardial infarction) occurred in 14% and 20% of the patients at 12 and 24 months, respectively. The rate of ischemia-driven TLR was 1.5% at 12 months and 3.0% at 24 months. No acute closure of the treated vessel occurred. Bailout stenting was needed in 10% of the PCIs. The incidence of significant bleeding was 9% at 12 months. Conclusions This is the first study to show that PCI using DCB after preparation of calcified lesions with rotablation is safe and effective. This novel strategy may be considered especially in patients with a bleeding risk such as those using an oral anticoagulant.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::3a05dd5171ceaf3885d0193956e17240Test
https://doi.org/10.1111/joic.12366Test

المؤلفون: Marjo Piironen, Juhani Airaksinen, Y. Antero Kesäniemi, Olavi Ukkola, Heli Koukkunen, Aki S. Havulinna, Veikko Salomaa, Seppo Lehto, Juha Mustonen, Matti Ketonen, Heikki V. Huikuri

المصدر: European Journal of Preventive Cardiology. 24:274-280

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Acute coronary syndrome, Time Factors, Epidemiology, Population, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Risk Assessment, Disease-Free Survival, Coronary artery disease, 03 medical and health sciences, Age Distribution, 0302 clinical medicine, Risk Factors, Cause of Death, Internal medicine, medicine, Humans, Registries, 030212 general & internal medicine, Myocardial infarction, Acute Coronary Syndrome, Sex Distribution, education, Finland, Aged, Proportional Hazards Models, Cause of death, Aged, 80 and over, education.field_of_study, business.industry, Proportional hazards model, Incidence (epidemiology), Hazard ratio, ta3121, Middle Aged, medicine.disease, Disease Progression, Cardiology, Female, Cardiology and Cardiovascular Medicine, business

الوصف: Background Coronary heart disease incidence, mortality and short-term case-fatality have improved substantially during the past decades. Recent changes in the long-term prognosis among survivors of acute coronary syndrome are less well known. Our aim was to investigate the long-term prognosis of acute coronary syndrome. Design An observational myocardial infarction register study. Methods Data was derived from the population based Finnish Myocardial Infarction register. Patients aged 35 or higher, who had their first acute coronary syndrome during 1993-2011 and survived the first 28 days, were included in the analysis ( n = 13,336). Endpoints were fatal and non-fatal cardiovascular disease events and all-cause mortality at one year and three years after the index event. We also compared the prognosis of acute coronary syndrome survivors with the prognosis of an apparently healthy population with the same age, sex and area of residence, derived from the FINRISK study. Results Significant declines over time were observed in the risk of a new cardiovascular disease event. At three year follow-up the age- and study area-adjusted hazard ratio per calendar year was 0.969 (95% confidence interval 0.960-0.977, p = 4.63 × 10-13) among men and 0.969 (95% confidence interval 0.961-0.978, p = 1.01 × 10-11) among women. Despite the improvement in prognosis, the age-standardized three year cardiovascular disease free survival of acute coronary syndrome patients was significantly lower than in the FINRISK control group (for men p = 6.64 × 10-27 and for women p = 2.11 × 10-15). Conclusion The prognosis of acute coronary syndrome survivors has improved during the 18-year period but is still much worse than the prognosis of comparable general population.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6f08b93c1a7e3f1dcd42a5f88464b398Test
https://doi.org/10.1177/2047487316679522Test

المؤلفون: Tiina Laatikainen, Riikka-Leena Leskelä, Anna Torvinen, Juha Mustonen, Vesa Virtanen, Tuomas T. Rissanen, Fredrik Herse, Mikko Nuutinen

المصدر: Atherosclerosis. 296

مصطلحات موضوعية: 0301 basic medicine, Male, Acute coronary syndrome, medicine.medical_specialty, Population, Aftercare, Comorbidity, Coronary Artery Disease, 030204 cardiovascular system & hematology, Logistic regression, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes Mellitus, Secondary Prevention, Medicine, Humans, Medical prescription, Acute Coronary Syndrome, education, Finland, Cause of death, Aged, Retrospective Studies, Secondary prevention, Aged, 80 and over, education.field_of_study, business.industry, Public health, Cholesterol, LDL, medicine.disease, 030104 developmental biology, Treatment Outcome, Hypertension, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, business, Goals, Follow-Up Studies

الوصف: Ischemic heart diseases are the main cause of death worldwide, therefore secondary prevention and treatment of coronary artery disease (CAD) are highly significant for public health and mortality. The objective of this study is to evaluate LDL cholesterol (LDL-C) levels as outcomes of secondary prevention of CAD in Finland up to 24 months after being diagnosed with acute coronary syndrome (ACS). This retrospective analysis of patients with ACS was conducted in two areas of Finland that have a combined population of 400,000.The data used in the study covered all outpatient visits, inpatient episodes, prescriptions and LDL-C results for ACS patients during 2011-2015. To evaluate the outcome of the prevention, three separate measurements of patients' LDL-C levels were considered: baseline, first follow-up and final follow-up. The factors associated with reaching treatment goal were identified using logistic regression analysis.32% of ACS patients achieved the treatment goal (LDL-C1.8 mmol/l) at the end of the 24-month follow-up period, but 21% of patients fluctuated between being on and above target.Two thirds of CAD patients with ACS and on statin therapy do not achieve LDL-C treatment target recommended by the guidelines. Since LDL-C levels fluctuate in the follow-up, a low level during the first 12 months after the acute event does not guarantee the maintenance of the results in the long term. Hence, LDL-C levels should be monitored at least on an yearly basis on follow-ups, and treatment adapted accordingly.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0dd26ed1d275142afe8cff91dbe9abb4Test
https://pubmed.ncbi.nlm.nih.gov/32284151Test