Publications by authors named "Heikki Miettinen"
Article Synopsis
- The study focused on how well physicians and patients agree on the severity of angina symptoms in those with stable coronary artery disease (CAD).
- Results indicated that in about half of the cases, there was agreement between physician and patient-reported scores, but physicians tended to report milder symptoms more often.
- The findings suggest that patient-reported symptoms should be prioritized in treatment decisions, as physicians underestimated symptoms in about one-third of cases.
Aims And Objectives: The study was conducted to describe long-term perceived health among patients after a percutaneous coronary intervention as well as clarify the associations between perceived health and various factors.
Background: Perceived health is an important outcome for coronary heart disease patients who have undergone percutaneous coronary intervention. Poor perceived health predicts low adherence to treatment, morbidity and mortality.
Article Synopsis
- The study evaluated the correlation between changes in health-related quality of life (HRQoL) measured by the 15D instrument and angina severity graded by the Canadian Cardiovascular Society (CCS) in coronary artery disease patients over 12 months.
- Both instruments showed a moderate correlation (r = 0.33) in assessing the patients' conditions, and this correlation was consistent across different age groups, sexes, and treatment methods.
- The findings suggest that while the CCS may miss some broader benefits or harms of treatment, the 15D might not adequately capture disease-specific symptoms, indicating the need for using both types of instruments together for a comprehensive evaluation.
Article Synopsis
- The study investigates how well various health measurement tools (PRO instruments) assess quality of life in coronary artery disease (CAD) patients compared to a standard set from ICHOM.
- The research involved 297 patients and compared their health status using different questionnaires, looking for correlations between their initial scores and those after one year.
- Results showed that while there were noticeable correlations and a significant factor related to "Breathing-related physical activity," the overall changes in scores over a year were only moderately related.
Background Cardiac sarcoidosis (CS) and giant cell myocarditis (GCM) share many histopathologic and clinical features. Whether they are parts of a one-disease continuum has been discussed. Methods and Results We compared medical record data of 351 CS and 28 GCM cases diagnosed in Finland since the late 1980s and followed until February 2018 for a composite end point of cardiac death, aborted sudden death, and heart transplantation.
View Article and Find Full Text PDFAim: To test the hypothetical model of adherence to treatment among patients with coronary disease after percutaneous coronary intervention.
Design: A descriptive, explanatory, cross-sectional survey.
Methods: The study was conducted in 2013 with 416 patients in five hospitals in Finland.
Background: Adherence to treatment is a crucial factor in preventing the progression of coronary heart disease. More evidence of the predictors of long-term adherence is needed.
Aims: The purpose of this study was to identify the predictive factors of adherence to treatment six years after percutaneous coronary intervention.
Aims: We studied the purchases of medical therapy recommended for coronary artery disease patients before and after elective revascularisation (percutaneous coronary intervention (PCI) or coronary bypass grafting (CABG)).
Methods: All patients who underwent an elective PCI (N = 1557) or CABG (N = 1768) at the Heart Center, Kuopio University hospital between 2007 and 2014 were included. Data were collected from the hospital's coronary register and national registers, and obtained for 3 years before and 1 year after the revascularisation.
Background: Adherence to treatment is essential to prevent the progression of coronary heart disease (CHD), which is the most common cause of death among women. Coronary heart disease in women has special characteristics: the conventional risk factors are more harmful to women than men, accumulation of risk factors is common, and women have nontraditional risk factors such as gestational diabetes and preeclampsia. In addition, worse outcomes, higher incidence of death, and complications after percutaneous coronary intervention have been reported more often among females than among male patients.
View Article and Find Full Text PDFAims: The present study was done to assess the role of sudden cardiac death (SCD) among the presenting manifestations of and fatalities from cardiac sarcoidosis (CS).
Methods And Results: We analysed altogether 351 cases of CS presenting from year 1998 through 2015 in Finland. There were 262 patients with a clinical diagnosis and treatment of CS, 27 patients with an initial lifetime diagnosis of giant cell myocarditis that was later converted to CS, and 62 cases detected at autopsy and identified by screening >820 000 death certificates from the national cause-of-death registry.
Outcome of Cardiac Sarcoidosis Presenting With High-Grade Atrioventricular Block.
Circ Arrhythm Electrophysiol
August 2018
Background: Symptomatic high-grade atrioventricular block (AVB) is the most common and often the only presenting manifestation (lone AVB) of cardiac sarcoidosis. Implantation of an intracardiac cardioverter defibrillator instead of a pacemaker is recommended, but the true risk of fatal arrhythmia, one incident to lone AVB in particular, remains poorly known.
Methods: We used Myocardial Inflammatory Diseases in Finland Study Group Registry to analyze the presentations, left ventricular (LV) function, pacemaker therapy, and ventricular arrhythmias in cardiac sarcoidosis.
Aims And Objectives: To identify the predictors of adherence in patients with coronary heart disease after a percutaneous coronary intervention.
Background: Adherence is a key factor in preventing the progression of coronary heart disease.
Design: An analytical multihospital survey study.
Article Synopsis
- The study examines the representativeness of patient-reported outcomes (PROs) from a health-related quality of life questionnaire in a cardiology unit, highlighting potential biases in the data.
- Data from CABG and PCI patients revealed that older and sicker individuals were less likely to respond to baseline questionnaires, suggesting a skewed sample.
- The findings emphasize the need to be cautious when interpreting PROs, as they may not accurately reflect the entire patient population, particularly if resources for data collection are insufficient.
Aim: Can focusing the adverse events search to patients with poor patient-reported outcome help in targeting adverse event detection?
Patients & Methods: Coronary artery revascularization patients of the Kuopio University Hospital from June 2012 to August 2014 categorized into those with clinically significant improvement (15D score change ≥0.015, n = 81) or deterioration (change ≥-0.015, n = 64) in post-intervention health-related quality of life.
Aims And Objectives: To describe perceived social support among patients with coronary heart disease following percutaneous coronary intervention.
Background: A low level of social support is considered a risk factor for coronary heart disease in healthy individuals and reduces the likelihood that people diagnosed with coronary heart disease will have a good prognosis.
Design: A descriptive cross-sectional study.
Introduction: Administrative registers provide an attractive data source for real-life effectiveness studies. The validity of coronary artery disease diagnoses in the Finnish National Hospital Discharge Register (HDR) is high but the validity of revascularization procedure codes (percutaneous coronary intervention; PCI and coronary artery bypass grafting; CABG) are unknown.
Methods: All elective PCIs (n = 1771) and CABGs (n = 1819), performed at the Heart Center, Kuopio University Hospital, Finland between years 2007 and 2014 were identified from the unit's Special Electronic Medical Records (sEMR).
Article Synopsis
- The study compares two health-related quality-of-life (HRQoL) measures, EQ-5D and 15D, in patients undergoing elective coronary artery bypass grafting (CABG) to assess their effectiveness.
- Conducted on 182 patients at Kuopio University Hospital between 2012 and 2014, the study found that the EQ-5D had lower baseline scores and poor agreement with the 15D instrument, but was better at distinguishing patient groups.
- Results showed that while both measures indicated significant patient improvement after one year, the EQ-5D required fewer patients to demonstrate an additional quality-adjusted life year (QALY) gain compared to the 15D, suggesting they are not interchangeable.
Histologic proof of granulomatous inflammation is prerequisite for the diagnosis of cardiac sarcoidosis (CS). Because of the limited sensitivity of endomyocardial biopsy (EMB), confirmation of sarcoidosis often has to be acquired from extracardiac biopsies. We set out to review our experience of F-18-fluorodeoxyglucose positron emission tomography (F-18-FDG PET) in guiding extracardiac tissue biopsies in suspected CS.
View Article and Find Full Text PDFEvaluation and treatment of cardiac sarcoidosis (CS) suffer from lack of sensitive and easily repeatable markers of disease activity. We studied measurements of high-sensitivity cardiac troponin T or troponin I (hs-cTnT/I) taken at presentation and during treatment in 62 patients with new-onset CS (48 women, mean age 49 years). Hs-cTnT was measured in 50 patients and was elevated (>13 ng/L) at presentation in 26 of them (52%).
View Article and Find Full Text PDFAim: To test the Theory of Adherence of People with Chronic Disease with regard to adherence to treatment among patients with coronary heart disease after a percutaneous coronary intervention.
Background: Increased knowledge of the concept of adherence is needed for the development of nursing interventions and nursing guidelines for patients with coronary heart disease.
Design: A cross-sectional, multi-centre study.
Background: This study was designed to assess the epidemiology, characteristics, and outcome of cardiac sarcoidosis (CS) in Finland.
Methods And Results: We identified in retrospect all adult (>18 years of age) patients diagnosed with histologically confirmed CS in Finland between 1988 and 2012. A total of 110 patients (71 women) 51±9 years of age (mean±SD) were found and followed up for outcome events to the end of 2013.
More than 10,000 percutaneous coronary angioplasties are performed in Finland annually. We examined in a three-year follow-up the results of percutaneous coronary angioplasty performed for 875 patients at the Kuopio University Hospital. Procedural and end-point data were collected from patient records and by mail inquiry.
View Article and Find Full Text PDFObjective: Transcatheter valve-in-valve implantation has emerged as an option, in addition to reoperative surgical aortic valve replacement, to treat failed biologic heart valve substitutes. However, the clinical experience with this approach is still limited. We report the comprehensive experience of transcatheter valve-in-valve implantation in the Nordic countries from May 2008 to January 2012.
View Article and Find Full Text PDFBackground: It is unknown whether the preferred 1-stent bifurcation stenting approach with stenting of the main vessel (MV) and optional side branch stenting using drug-eluting stents should be finalized by a kissing balloon dilatation (FKBD). Therefore, we compared strategies of MV stenting with and without FKBD.
Methods And Results: We randomized 477 patients with a bifurcation lesion to FKBD (n=238) or no FKBD (n=239) after MV stenting.
Background And Design: The recent introduction of sensitive markers of myocardial injury is likely to affect the epidemiology of coronary heart disease (CHD). The American Heart Association together with other societies and research agencies have recently published a new definition on acute CHD to improve consistency in epidemiological and clinical studies (referred here as the '2003 definition').
Methods: In this study we compare the data on CHD events in the Finnish National Hospital Discharge Register (HDR) and the Causes of Death Register (CDR) with the population-based myocardial infarction (MI) register, FINMONICA/FINAMI.