Aging of the population may not lead to an increase in the numbers of acute coronary events: a community surveillance study and modelled forecast of the future.

Objective: To examine the incidence, mortality and case fatality of acute coronary syndrome (ACS) in Finland during 1993-2007 and to create forecasts of the absolute numbers of ACS cases in the future, taking into account the aging of the population.

Design: Community surveillance study and modelled forecasts of the future.

Setting And Methods: Two sets of population-based coronary event register data from Finland (FINAMI and the National Cardiovascular Disease Register (CVDR)).

Prognosis of acute coronary events is worse in patients living alone: the FINAMI myocardial infarction register.

Background: Single living has been associated with a worse prognosis of acute coronary syndrome (ACS). We aimed to study the relation of sociodemographic characteristics to the morbidity, mortality, and case fatality (CF) of ACS in a large population-based ACS register.

Methods: The population-based FINAMI myocardial infarction register recorded 15,330 cases of ACS among persons aged 35-99 years in Finland in 1993-2002.

Socioeconomic inequalities in the morbidity and mortality of acute coronary events in Finland: 1988 to 2002.

Purpose: To examine the changes in socioeconomic disparities in the incidence of coronary heart disease (CHD) and mortality in Finland and to analyze the effects of the severe economic recession of the early 1990s on these disparities.

Methods: The population-based FINAMI Myocardial Infarction (MI) register recorded all suspected MI events among men and women ages 35 to 99 years in four geographical areas of Finland. Record linkage with the files of Statistics Finland provided us with detailed information on the indicators of socioeconomic status (SES; income, education, and profession).

Myocardial infarction events and cardiovascular risk factor levels in Finnish- and Swedish-speaking populations of Finland.

BACKGROUND. The Swedish-speaking minority of Finland is unique, because it has a higher socioeconomic status (SES) and longer life expectancy than the Finnish-speaking majority. We hypothesized that this minority may have a lower attack rate of coronary events and analysed whether this could be explained by their higher SES.

Visual assessment of [(11)C]PIB PET in patients with cognitive impairment.

Purpose: The aim of this study was to evaluate the visual assessment of positron emission tomography images of N-[methyl-11C]2-(4'-methylaminophenyl)-6-hydroxybenzothiazole ([11C]PIB) in a patient population with mild to moderate memory impairment or dementia.

Methods: We compared the visual ratings of two readers using kappa statistics and correlated the results of visual and quantitative region of interest (ROI) analyses. The one reader had good experience in evaluating PIB images and the other had little previous experience.

Lower recurrence risk through mammographic screening reduces breast cancer treatment costs.

Mammographic screening is associated with a reduced risk of breast cancer recurrence. The objective of the study was to evaluate treatment costs due to breast cancer recurrence in relation to patients' use of mammographic screening, consecutively collected in a defined population. The study included 418 women exposed to screening and 109 women unexposed to screening diagnosed with stage I-III breast cancer.

Stroke morbidity in Swedish- and Finnish-speaking populations of Turku, Finland.

Objectives: To examine differences in the morbidity and mortality of stroke between the Finnish- and Swedish-speaking populations in Turku, taking into account the socioeconomic differences between these groups.

Design: The population-based FINMONICA and FINSTROKE stroke registers recorded 5,135 stroke events among persons aged 25-99 years in Turku during 1988-1998. Events in persons aged > or =75 years were not registered in 1993-1995.

Coronary events in persons aged 75 years or older in Finland from 1995 to 2002: the FINAMI study.

The authors used population-based myocardial infarction (MI) register data to examine trends in incidence, case fatality, treatment strategies of MI, and coronary heart disease (CHD) mortality in persons aged 75 to 99 years in 4 areas of Finland during 1995 through 2002. This age group contributed 53% (n=13,977) of all CHD events, and 65% occurred in women. CHD mortality declined among men annually by 3.

The validation of the Finnish Hospital Discharge Register and Causes of Death Register data on stroke diagnoses.

Background And Purpose: Administrative registers, like hospital discharge registers and causes of death registers are used for the monitoring of disease incidences and in the follow-up studies. Obtaining reliable results requires that the diagnoses in these registers are correct and the coverage of the registers is high. The purpose of this study was to evaluate the validity of the Finnish hospital discharge registers and causes of death registers stroke diagnoses against the population-based FINSTROKE register.

The effect of correcting for troponins on trends in coronary heart disease events in Finland during 1993-2002: the FINAMI study.

Aims: The object of this study is to analyse the trends in coronary events in Finland during 1993-2002, correcting for the effect of troponins.

Methods And Results: A population-based myocardial infarction register recorded all coronary events (n=14 782) in four geographical areas of Finland during 1993-2002. Correction coefficients for the effect of troponins were calculated on the basis of 4359 coronary events, with simultaneous determination of troponins and the 'old' enzymatic markers of myocardial injury.

Population-based mammography screening results in substantial savings in treatment costs for fatal breast cancer.

Aims: The aim was to assess the effect of population-based mammography screening on treatment costs for fatal breast cancer in Turku, Finland.

Materials And Methods: The study included 556 women with invasive breast cancer, diagnosed at the age of 40-74 years in 1987-1993: 427 in the screened group (screen-detected or interval cancer) and 129 in the unscreened group (not yet invited or refused screening). Both groups were followed up for 8 years from diagnosis.

Diabetes worsens the outcome of acute ischemic stroke.

Objective: To characterize acute stroke events in diabetic patients in a population-based stroke register and to determine the influence of diabetes on the outcome of acute stroke.

Methods: Four thousand three hundred and ninety patients were recorded in the FINMONICA and FINSTROKE registers after their first ischemic stroke from 1990 to 1998. We followed mortality and stroke outcome for up to 4 weeks after the onset of acute stroke.

A new definition for myocardial infarction: what difference does it make?

Aims: As a response to changing diagnostic tools of myocardial infarction (MI), new case definitions for acute coronary events were published in 2003 as the American Heart Association Scientific Statement. We assessed the new definition in hospitalized patients in a large population-based MI register study.

Methods And Results: We identified all suspected acute coronary syndromes with data either on troponin T or on troponin I and at least one of the enzymatic markers of myocardial injury (n=6104).

The validity of the Finnish Hospital Discharge Register and Causes of Death Register data on coronary heart disease.

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.

Liver echogenicity: relation to systemic blood pressure and other components of the metabolic syndrome.

We studied the impact of liver echogenicity among other potential predictors of systemic blood pressure (BP) and the metabolic syndrome. 38 persons (32 males, six females, aged 29 to 66) had their liver echogenicities scored, BPs measured and standard serum laboratory tests studied. There was a significant correlation between both systolic (r=0.

Mammographic screening reduces risk of breast carcinoma recurrence.

Background: The current report is a long-term evaluation of breast carcinoma recurrence, factors predicting recurrence, and postrecurrence prognosis in relation to patients' use of service screening, which has been provided in Turku, Finland, since 1987 for women ages 40-74 years.

Methods: The current study included 527 invasive breast carcinomas: 418 in the screening group (which included screen-detected and interval malignancies) and 109 in the nonscreening group (which included breast carcinomas detected before initial screening and those detected in patients who chose not to undergo screening). These breast carcinomas were diagnosed among women ages 40-74 years between 1987 and 1993, with follow-up extending until the end of 2001.

Declining incidence and mortality of stroke in persons aged > or = 75 years in Finland; the FINSTROKE study.

Background: The average life expectancy of a person aged 75 in Finland is approximately 10 years. A substantial threat to the quality of life during these years is stroke, which is common among the elderly, may hamper independent living and places a substantial burden on health care resources. The aim of the present study was to analyse the trends in incidence, mortality and prognosis of acute stroke events in persons aged > or = 75 years in Finland.

Lower costs of hospital treatment of breast cancer through a population-based mammography screening programme.

Background: The objective of this study was to evaluate the hospital treatment costs of invasive breast cancer in relation to the mode of detection, i.e. by mammography screening, between screenings or without screening during a population-based mammography screening programme, which started in 1987 among 36,000 women aged 40 to 74 years in the city of Turku, Southwest Finland.

Secondary prevention of coronary heart disease is disappointing among patients of working age.

Background: The risk factors underlying coronary heart disease (CHD) are well known.

Objective: The purpose of this study was to evaluate risk factors related to secondary prevention of working-age CHD patients.

Methods: CHD patients with (n = 139) and without (n = 203) myocardial infarction were selected from a postal questionnaire study (n = 21 101) of randomly selected Finns aged 20-54 years (HeSSup study).

Continuous 15-year decrease in incidence and mortality of stroke in Finland: the FINSTROKE study.

Background And Purpose: The purpose of this study was to analyze the incidence and mortality trends in stroke events among persons 25 to 74 years of age in Finland during 1983 to 1997.

Methods: The population-based FINSTROKE register recorded 5650 new strokes among persons 25 to 74 years of age in 2 geographical areas of Finland: 2770 in the Kuopio area (east central Finland) and 2880 in Turku (southwestern Finland). Of these, 3065 were men and 2585 were women.

Significant improvement in breast cancer survival through population-based mammography screening.

The purpose of this study was to evaluate the effect of population-based mammography screening on survival. A total of 176 908 screening examinations were performed in 36 000 women aged 40-74 during the years 1987-1997. Screen-detected and interval primary invasive breast cancers (n=685, screened) were more often smaller (P<0.

Eleven-year trends of stroke in Turku, Finland.

The Turku Stroke Register included stroke events at all ages during the years 1982-1992. The incidence of stroke declined in all age groups, even in the oldest one. An even steeper decline was observed in mortality from stroke.

The risk of stroke following coronary revascularization -- a population-based long-term follow-up study.

Objective: To study the incidence and risk factors of stroke after coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA).

Design: During 1983-1992, coronary revascularization procedures (n = 2160) were recorded in patients aged 35-64 years as part of the population-based FINMONICA Myocardial Infarction Register. The FINMONICA Stroke Register and National Hospital Discharge Register were used to ascertain subsequent stroke events in such patients.