Publications by authors named "Mustonen P"

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.

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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.

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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.
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Background And Aims: We examined temporal trends and age-related differences in the prevalence of vascular diseases and in their association with ischemic stroke (IS) risk in patients with atrial fibrillation (AF).

Methods: The registry-based FinACAF study covered all patients with AF in Finland during 2007-2018. Incidence rate ratios (IRRs) of IS were computed with Poisson regression, and the interaction of vascular diseases with age and calendar year period was assessed.

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Objectives: Atrial fibrillation (AF) is associated with increased mortality. Previous studies have reported conflicting results in temporal trends of mortality after AF diagnosis. We aim to address this disparity by investigating the 1-year mortality and causes of death in Finnish patients diagnosed with AF between 2010 and 2017.

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Article Synopsis
  • The study analyzed changes in the predictive value of a risk score (CHADS-VA) for ischaemic stroke in patients with atrial fibrillation (AF) in Finland from 2007 to 2018.
  • Researchers found that early on, the CHADS-VA score was less effective than the CHADS-VASc score, but this changed over time, with CHADS-VA performing better by the end of the study.
  • The results suggest that as the risk associated with female sex decreased, the CHADS-VA score gained relevance, indicating a need to adapt stroke risk assessments over time.
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  • 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.
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Introduction: Chronic kidney disease (CKD) is associated with an increased incidence of atrial fibrillation (AF). Also, patients with AF are prone to adverse kidney outcomes. We examined comorbidities and medication use in patients with CKD and incident AF.

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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.

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Objectives: The objective of this study was primarily to compare four-dimensional flow magnetic resonance imaging metrics in the ascending aorta (AA) of patients with right-left fusion type bicuspid aortic valve (RL-BAV) and repaired coarctation of the aorta (CoA) to RL-BAV without CoA. Metrics of patients with RL-BAV were also compared to the matched group of patients with common tricuspid aortic valve (TAV).

Methods: Eleven patients with RL-BAV and CoA, 11 patients with RL-BAV without CoA and 22 controls with TAV were investigated.

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Background 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.

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Introduction: Medicine shortages prevail as a worldwide problem causing life-threatening situations for adults and children. Epinephrine auto-injectors are used for serious allergic reactions called anaphylaxis, and alternative auto-injectors are not always available in pharmacies. Healthcare professionals in Finland use the dedicated internet source, Physician's Database (PD), when seeking medical information in practice, while Health Library (HL) provides health information for citizens (S1 Data).

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The Finnish Gutsy Go programme is a positive youth development intervention designed to enhance adolescents' psychosocial well-being by enabling eighth-grade students to develop and execute good deeds within the community. This study aimed to explore the effect of the Gutsy Go programme on adolescents' positive mental health, experience of social inclusion, and social competence using a quasi-experimental study design. Data were collected with electronic questionnaires at baseline ( = 236 programme participants and = 303 controls) and follow-up two weeks after the programme ( = 126, 54.

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Background: Many patients with chronic heart failure (HF) experience a reduced health status, leading to readmission after hospitalization despite receiving conventional care. Telemonitoring approaches aim to improve the early detection of HF decompensations and prevent readmissions. However, knowledge about the impact of telemonitoring on preventing readmissions and related costs remains scarce.

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Maternal prenatal distress can participate in the programming of offspring development, in which exposure to altered maternal long-term cortisol levels as measured by hair cortisol concentrations (HCC) may contribute. Yet, studies investigating whether and how maternal prenatal HCC associates with problems in child socioemotional development are scarce. Furthermore, questions remain regarding the timing and potential sex-specificity of fetal exposure to altered cortisol levels and whether there are interactions with maternal prenatal distress, such as depressive symptoms.

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Background: Limited data exist on the temporal relationship between new-onset atrial fibrillation (AF) and ischemic stroke and its impact on patients' clinical characteristics and mortality.

Methods: A population-based registry-linkage database includes all patients with new-onset AF in Finland from 2007 to 2018. Ischemic stroke temporally associated with AF (ISTAF) was defined as an ischemic stroke occurring within ±30 days from the first AF diagnosis.

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Objectives: Value-based healthcare (VBHC) is considered the most promising guiding principle for a new generation of health service production. Many countries have attempted to apply VBHC to managerial and clinical decision-making. However, implementation remains in its infancy and varies between countries.

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Myocardial infarction (MI) and atrial fibrillation (AF) are commonly seen in the same patient. In this study, we evaluated the temporal relations and prognosis of MI and AF. This is a substudy of the nationwide registry-based Finnish Anticoagulation in Atrial Fibrillation (FinACAF) study, comprising all Finnish patients with new-onset AF from 2010 to 2017.

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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.

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Aims: We assessed the temporal trends in the prevalence of diabetes and in its associations with outcomes among patients with atrial fibrillation (AF).

Methods: The registry-based FinACAF study covered all patients with incident AF in Finland between 2007 and 2018. Ischemic stroke (IS) and mortality rates were computed using Poisson regression model.

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Aims: Rural-urban disparities have been reported in the outcomes of cardiovascular diseases. We assessed whether rural-urban or other geographical disparities exist in the risk of ischemic stroke (IS) and death in patients with atrial fibrillation (AF) in Finland.

Methods: The registry-based FinACAF cohort study covers all patients with AF from all levels of care in Finland from 2007 to 2018.

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Objectives: The impact of oral anticoagulants (OACs) on the need of long-term care (LTC) in the aging and multimorbid population of patients with atrial fibrillation (AF) is unknown. We conducted a nationwide cohort study to evaluate the effect of OACs on the need of LTC.

Design: Retrospective nationwide cohort study.

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Article Synopsis
  • Animal studies indicate a two-way communication between gut microbiota and the HPA axis, but human research, particularly in young children, is still limited.* -
  • This study examined the relationship between HPA axis activity (measured by hormone levels in hair) and gut microbiota profiles in healthy toddlers, revealing associations with specific gut bacteria but not with overall diversity.* -
  • The results suggest that the functioning of the HPA axis may influence certain gut bacterial populations, but further investigation is needed to understand the implications for child health and development.*
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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.

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