Publications by authors named "Aapo L Aro"
Background: Unidentified cardiovascular risk factors may account for approximately half of sudden deaths, a devastating event with limited preventive tools. We investigated whether adrenal histopathology suggestive of primary aldosteronism, pheochromocytoma, or adrenal masses could explain part of the risk for disease-induced sudden death (DSD).
Methods: In this study, autopsies and histopathological analyses, including aldosterone synthase staining of adrenal glands, were performed on 403 consecutive individuals who experienced sudden death.
Background: Atrial fibrillation (AF) is a major risk factor for ischemic stroke (IS), but whether the magnitude of this risk has changed over time is unknown.
Objectives: This study sought to investigate temporal trends in IS rates in patients with incident AF before oral anticoagulant agent (OAC) therapy.
Methods: The nationwide FinACAF (Finnish Anticoagulation in Atrial Fibrillation) study covers patients with AF at all levels of care in Finland from 2007 to 2018.
Background: Catheter ablation is a well-established treatment to prevent atrial fibrillation (AF) and atrial flutter (AFL) recurrences and to relieve symptoms, whereas pacemaker implantation and atrioventricular node (AVN) ablation is used for rate control when medical therapy fails.
Aims: We investigated temporal trends and patient characteristics in catheter ablation procedures for AF, AFL and AVN in Finland between 2012-2018.
Methods: Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) is a registry-based study including all patients with AF or AFL in Finland between 2012-2018.
Article Synopsis
- Atrial fibrillation (AF) patients often need rhythm control therapy, and the study explored whether there are gender disparities in the use of antiarrhythmic therapies (AATs) among these patients in Finland from 2007-2018.
- Out of 229,565 patients studied, women were older, had different health profiles compared to men, and were treated with AATs less frequently, with 17.6% of women and 25.1% of men receiving treatment.
- Interestingly, while women received antiarrhythmic drugs more often across all ages, they underwent fewer cardioversion and ablation procedures, especially those under 65 years old.
Article Synopsis
- The study investigates how time-in-therapeutic-range (TTR) impacts the effectiveness and safety of warfarin compared to direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF).
- Researchers analyzed data from a nationwide Finnish study between 2011 and 2018, using hazard ratios to assess risks of ischaemic stroke, intracranial hemorrhage, and mortality among patients using warfarin and different DOACs.
- Results indicated that lower TTR was associated with higher risks of complications and mortality in warfarin users, while differences in outcomes between high TTR groups and standard dose DOACs were minimal.
Aims: Elective cardioversion (ECV) is routinely used in atrial fibrillation (AF) to restore sinus rhythm. However, it includes a risk of thromboembolism even during adequate oral anticoagulation treatment. The aim of this study was to evaluate the risk of thromboembolic and bleeding complications after ECV in a real-life setting utilizing data from a large AF population.
View Article and Find Full Text PDFBackground And Aims: Female sex has been linked with higher risk of ischaemic stroke (IS) in atrial fibrillation (AF), but no prior study has examined temporal trends in the IS risk associated with female sex.
Methods: The registry-linkage Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) study included all patients with AF in Finland from 2007 to 2018. Ischaemic stroke rates and rate ratios were computed.
Aims/hypothesis: Type 2 diabetes is associated with a high risk of sudden cardiac death (SCD), but the risk of dying from another cause (non-SCD) is proportionally even higher. The aim of the study was to identify easily available ECG-derived features associated with SCD, while considering the competing risk of dying from non-SCD causes.
Methods: In the SURDIAGENE (Survie, Diabete de type 2 et Genetique) French prospective cohort of individuals with type 2 diabetes, 15 baseline ECG parameters were interpreted among 1362 participants (mean age 65 years; HbA 62±17 mmol/mol [7.
Aims: To investigate sex-specific temporal trends in the initiation of oral anticoagulant (OAC) therapy among patients diagnosed with atrial fibrillation (AF) in Finland between 2007 and 2018.
Methods: The registry-linkage Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) Study included all patients with incident AF in Finland from 2007 to 2018. The primary outcome was the initiation of any OAC therapy.
Background Patients with aortic stenosis (AS) have been underrepresented in the trials evaluating direct oral anticoagulants (DOACs) in atrial fibrillation (AF). We aimed to assess whether AS impacts outcomes in patients with AF and estimate the effects of DOACs versus warfarin in patients with AF and AS. Methods and Results The registry-based FinACAF (Finnish Anticoagulation in Atrial Fibrillation) study covered all patients with AF diagnosed during 2007 to 2018 in Finland.
View Article and Find Full Text PDFTrends in treatment and outcomes of atrial fibrillation during 2007-17 in Finland.
Eur Heart J Qual Care Clin Outcomes
November 2023
Article Synopsis
- Guidelines for managing atrial fibrillation (AF) have significantly evolved, and a study examined trends in treatment and outcomes from 2007 to 2017 in Finland, assessing data from a nationwide cohort of 206,909 patients.
- The use of oral anticoagulants (OACs) rose dramatically from 43.6% to 76.3%, particularly among patients at higher risk for strokes, leading to a decrease in one-year mortality from 13.3% to 10.6% and a significant reduction in ischaemic strokes from 5.3% to 2.2%.
- Despite a rise in major bleeding events, catheter ablation for rhythm control saw continuous growth, while other rhythm
Article Synopsis
- In Finland, researchers studied if people living in rural areas get different heart treatments compared to those in cities when they have a heart condition called atrial fibrillation (AF).
- They looked at a lot of patients from 2010 to 2018 and found that overall, there weren't huge differences between rural and urban areas in using treatments.
- However, people in cities used a specific kind of treatment called antiarrhythmic drugs (AADs) a bit more than those in rural areas, suggesting cities might have slightly better access to some heart treatments.
Aims: To evaluate the prognostic significance of novel P-wave morphology descriptors in general population.
Methods And Results: Novel P-wave morphology variables were analyzed from orthogonal X-, Y-, Z-leads of the digitized electrocardiogram using a custom-made software in 6906 middle-aged subjects of the Mini-Finland Health Survey. A total of 3747 (54.
Background: In patients with atrial fibrillation (AF), socioeconomic disparities have been reported in the use of oral anticoagulant therapy and outcomes, but whether income also affects the utilization of antiarrhythmic therapies (AATs) for rhythm control is unknown. We assessed the hypothesis that AF patients with higher income are more likely to receive AATs.
Methods: The nationwide retrospective registry based FinACAF cohort study covers all patients with AF from all levels of care in Finland.
Aims: To investigate whether clockwise rotation (CWR) and counterclockwise rotation (CCWR) of electrocardiographic QRS transition zone is associated with mortality from all causes and cardiovascular diseases (CVD).
Methods: Studies were identified from searching of PubMed, EMBASE and the reference lists of relevant papers. Summary multivariate-adjusted hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) and 95% prediction intervals (PIs) were computed through meta-analysis.
Background: Atrial fibrillation (AF) patients with mental health conditions (MHCs) have higher incidence of ischaemic stroke (IS) than patients without MHC, but whether this results from direct impact of MHCs or relates to higher prevalence of comorbidities and differences in the use of oral anticoagulant (OAC) therapy is unclear. We assessed the hypothesis that MHCs independently increase the risk of IS in patients with incident AF.
Methods: The nationwide FinACAF cohort covered all 203,154 patients diagnosed with incident AF without previous IS or transient ischaemic attack in Finland during 2007-2018.
Background: QRS duration and corrected QT (QTc) interval have been associated with sudden cardiac death (SCD), but no data are available on the significance of repolarization component (JTc interval) of the QTc interval as an independent risk marker in the general population.
Objective: In this study, we sought to quantify the risk of SCD associated with QRS, QTc, and JTc intervals.
Methods: This study was conducted using data from 3 population cohorts from different eras, comprising a total of 20,058 individuals.
Background: Poor R-wave progression (PRWP) is a common clinical finding on the standard 12-lead electrocardiogram (ECG), but its prognostic significance is unclear.
Objective: The purpose of this study was to examine the prognosis associated with PRWP in terms of sudden cardiac death (SCD), cardiac death, and all-cause mortality in general population subjects with and without coronary artery disease (CAD).
Methods: Data and 12-lead ECGs were collected from a Finnish general population health examination survey conducted during 1978-1980 with follow-up until 2011.
Aims: Little is known about the effects of mental health conditions (MHCs) on the utilization of oral anticoagulation (OAC) therapy in atrial fibrillation (AF) patients. We aimed to assess whether MHCs affect initiation of OAC therapy among AF patients with special focus on non-vitamin K antagonist oral anticoagulants (NOACs).
Methods And Results: The Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) registry included all 239 222 patients diagnosed with incident AF during 2007-18 in Finland identified from national registries covering primary to tertiary care and drug purchases.
Background: Negative T-waves are associated with sudden cardiac death (SCD) risk in the general population. Whether flat T-waves also predict SCD is not known. The aim of the study was to examine the clinical characteristics and risk of SCD in general population subjects with flat T-waves.
View Article and Find Full Text PDFArticle Synopsis
- Finnish gelsolin amyloidosis (AGel amyloidosis) is a genetic condition affecting multiple body systems, leading to symptoms like heart problems, and this study specifically examined ECG findings and their connection to cardiac MRI results in affected patients.* -
- In a cohort of 51 AGel amyloidosis patients, 43% showed conduction disturbances on ECG, with various blocks and low voltage observed; most also displayed late gadolinium enhancement in cardiac MRI, indicating heart tissue changes.* -
- Although conduction issues were prevalent, needing a pacemaker was uncommon, and this suggests that the specific heart tissue pathology in AGel amyloidosis may impact the heart's electrical system differently compared to other types of cardiac amyloidosis
Background: Cardiac death is one of the leading causes of death and sudden cardiac death (SCD) is estimated to cause approximately 50% of cardiac deaths. Men have a higher cardiac mortality than women. Consequently, the mechanisms and risk markers of cardiac mortality are not as well defined in women as they are in men.
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