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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.

https://arctichealth.org/en/permalink/ahliterature114624
Source
Heart. 2013 Jul;99(13):954-9
Publication Type
Article
Date
Jul-2013
Author
Veikko Salomaa
Aki S Havulinna
Heli Koukkunen
Päivi Kärjä-Koskenkari
Arto Pietilä
Juha Mustonen
Matti Ketonen
Aapo Lehtonen
Pirjo Immonen-Räihä
Seppo Lehto
Juhani Airaksinen
Y Antero Kesäniemi
Author Affiliation
Department of Chronic Disease Prevention, THL-National Institute for Health and Welfare, PO Box 30, Helsinki FI-00271, Finland. veikko.salomaa@thl.fi
Source
Heart. 2013 Jul;99(13):954-9
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - epidemiology - mortality
Age Factors
Age of Onset
Aged
Aging
Bayes Theorem
Comorbidity
Computer simulation
Epidemiology - trends
Female
Finland - epidemiology
Forecasting
Humans
Incidence
Logistic Models
Male
Markov Chains
Middle Aged
Models, Statistical
Monte Carlo Method
Registries
Survivors - statistics & numerical data
Time Factors
Abstract
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.
Community surveillance study and modelled forecasts of the future.
Two sets of population-based coronary event register data from Finland (FINAMI and the National Cardiovascular Disease Register (CVDR)). Bayesian age-period-cohort (APC) modelling.
24 905 observed ACS events in the FINAMI register and 364 137 in CVDR.
Observed trends of ACS events during 1993-2007, forecasted numbers of ACS cases, and the prevalence of ACS survivors until the year 2050.
In the FINAMI register, the average annual declines in age-standardised incidence of ACS were 1.6% (p
PubMed ID
23598542 View in PubMed
Less detail

Answer to Dr. Sabours letter about our article 'the validity of hospital discharge register data on non-ST-elevation and ST-elevation myocardial infarction in Finland'.

https://arctichealth.org/en/permalink/ahliterature305416
Source
Scand Cardiovasc J. 2020 10; 54(5):338
Publication Type
Letter
Comment
Date
10-2020
Author
Marjo Okkonen
Aki S Havulinna
Olavi Ukkola
Veikko Salomaa
Author Affiliation
Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, and University of Oulu, Oulu, Finland.
Source
Scand Cardiovasc J. 2020 10; 54(5):338
Date
10-2020
Language
English
Publication Type
Letter
Comment
Keywords
Finland - epidemiology
Hospitals
Humans
Non-ST Elevated Myocardial Infarction
Patient Discharge
ST Elevation Myocardial Infarction - diagnosis - epidemiology - therapy
Notes
CommentOn: Scand Cardiovasc J. 2020 Apr;54(2):108-114 PMID 31701776
CommentOn: Scand Cardiovasc J. 2020 Oct;54(5):336-337 PMID 32998593
PubMed ID
32597231 View in PubMed
Less detail

Apolipoprotein A-I concentrations and risk of coronary artery disease: A Mendelian randomization study.

https://arctichealth.org/en/permalink/ahliterature311439
Source
Atherosclerosis. 2020 04; 299:56-63
Publication Type
Journal Article
Meta-Analysis
Multicenter Study
Research Support, Non-U.S. Gov't
Date
04-2020
Author
Minna K Karjalainen
Michael V Holmes
Qin Wang
Olga Anufrieva
Mika Kähönen
Terho Lehtimäki
Aki S Havulinna
Kati Kristiansson
Veikko Salomaa
Markus Perola
Jorma S Viikari
Olli T Raitakari
Marjo-Riitta Järvelin
Mika Ala-Korpela
Johannes Kettunen
Author Affiliation
Computational Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland; Biocenter Oulu, University of Oulu, Oulu, Finland. Electronic address: minna.k.karjalainen@oulu.fi.
Source
Atherosclerosis. 2020 04; 299:56-63
Date
04-2020
Language
English
Publication Type
Journal Article
Meta-Analysis
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Apolipoprotein A-I - blood - genetics - therapeutic use
Biomarkers - blood
Coronary Artery Disease - blood - epidemiology - genetics - prevention & control
Finland - epidemiology
Genetic Predisposition to Disease
Genome-Wide Association Study
Humans
Incidence
Mendelian Randomization Analysis
Phenotype
Polymorphism, Single Nucleotide
Prognosis
Protective factors
Risk assessment
Risk factors
Abstract
Apolipoprotein A-I (apoA-I) infusions represent a potential novel therapeutic approach for the prevention of coronary artery disease (CAD). Although circulating apoA-I concentrations inversely associate with risk of CAD, the evidence base of this representing a causal relationship is lacking. The aim was to assess the causal role of apoA-I using human genetics.
We identified a variant (rs12225230) in APOA1 locus that associated with circulating apoA-I concentrations (p 
Notes
CommentIn: Atherosclerosis. 2020 Apr;299:53-55 PMID 32178836
PubMed ID
32113648 View in PubMed
Less detail

Apolipoproteins and HDL cholesterol do not associate with the risk of future dementia and Alzheimer's disease: the National Finnish population study (FINRISK).

https://arctichealth.org/en/permalink/ahliterature287851
Source
Age (Dordr). 2016 Dec;38(5-6):465-473
Publication Type
Article
Date
Dec-2016
Author
Juho Tynkkynen
Jussi A Hernesniemi
Tiina Laatikainen
Aki S Havulinna
Jouko Sundvall
Jaana Leiviskä
Perttu Salo
Veikko Salomaa
Source
Age (Dordr). 2016 Dec;38(5-6):465-473
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alzheimer Disease - blood - epidemiology
Apolipoprotein A-I - blood
Apolipoproteins B - blood
Biomarkers - blood
Cholesterol, HDL - blood
Cohort Studies
European Continental Ancestry Group
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Proportional Hazards Models
Prospective Studies
Risk factors
Time Factors
Abstract
Data on associations of apolipoproteins A-I and B (apo A-I, apo B) and HDL cholesterol (HDL-C) with dementia and Alzheimer's disease (AD) are conflicting. Our aim was to examine, whether apo B, apoA-I, their ratio, or HDL-C are significant, independent predictors of incident dementia and AD in the general population free of dementia at baseline. We analyzed the results from two Finnish prospective population-based cohort studies in a total of 13,275 subjects aged 25 to 74?years with mainly Caucasian ethnicity. The follow-up time for both cohorts was 10?years. We used Cox proportional hazards regression to evaluate hazard ratios (HR) for incident dementia (including AD) (n?=?220) and for AD (n?=?154). Cumulative incidence function (CIF) analysis was also performed to adjust the results for competing risks of death. Adjusted for multiple dementia and AD risk factors, log-transformed apo A-I, log HDL-C, log apo B, and log apo B/A-I ratio were not associated with incident dementia or AD. HDL-C was inversely associated with AD risk when adjusted for competing risks but no other statistically significant associations were observed in the CIF analyses. Apo A-I, HDL-C, apo B, or apo B/A-I ratio were not associated with future dementia or AD. HDL-C was inversely associated with incident AD risk when adjusted for competing risks of death, but the finding is unlikely to be of clinical relevance. Our study does not support the use of these risk markers to predict incident dementia or AD.
Notes
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PubMed ID
27663235 View in PubMed
Less detail

Are coronary event rates declining slower in women than in men - evidence from two population-based myocardial infarction registers in Finland?

https://arctichealth.org/en/permalink/ahliterature160370
Source
BMC Cardiovasc Disord. 2007;7:35
Publication Type
Article
Date
2007
Author
Hanna-Riikka Lehto
Seppo Lehto
Aki S Havulinna
Matti Ketonen
Aapo Lehtonen
Y Antero Kesäniemi
Juhani Airaksinen
Veikko Salomaa
Author Affiliation
Turku University Hospital, Turku, Finland. hrleht@utu.fi
Source
BMC Cardiovasc Disord. 2007;7:35
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
Coronary Disease - epidemiology - mortality
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology - mortality
Population Surveillance
Registries - statistics & numerical data
Research Design
Sex Distribution
Sex Factors
Time Factors
Abstract
Studies have suggested that the prevention and treatment of coronary heart disease may not have been as effective in women as in men. Therefore, we aimed to examine whether the incidence, attack rate and mortality of myocardial infarction (MI) events have declined less in women than in men.
Two large population-based MI registers, the FINAMI register and the Finnish Cardiovascular Disease Register (CVDR) were used for comparing the event rates among men and women aged > or =35 years in two time periods, 1994-1996 and 2000-2002.
In the FINAMI register a total of 5,252 events were recorded in men and 4,898 in women. Corresponding numbers in the CVDR were 78,709 and 70,464. Both FINAMI and CVDR data suggested smaller declines in incidence and attack rate of MI events in women than in men. In CVDR data the decline in mortality was also smaller in women than in men, while in FINAMI data this difference did not reach statistical significance. In the large CVDR data set, negative binomial regression models revealed smaller declines in incidence (p = 0.006), attack rate (p = 0.008) and mortality (p = 0.04) in women than in men aged or =55 years no difference was observed between women and men.
The incidence and attack rate of MI events have declined less in women aged
Notes
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PubMed ID
17997825 View in PubMed
Less detail

Association of structural variation with cardiometabolic traits in Finns.

https://arctichealth.org/en/permalink/ahliterature312166
Source
Am J Hum Genet. 2021 04 01; 108(4):583-596
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
04-01-2021
Author
Lei Chen
Haley J Abel
Indraniel Das
David E Larson
Liron Ganel
Krishna L Kanchi
Allison A Regier
Erica P Young
Chul Joo Kang
Alexandra J Scott
Colby Chiang
Xinxin Wang
Shuangjia Lu
Ryan Christ
Susan K Service
Charleston W K Chiang
Aki S Havulinna
Johanna Kuusisto
Michael Boehnke
Markku Laakso
Aarno Palotie
Samuli Ripatti
Nelson B Freimer
Adam E Locke
Nathan O Stitziel
Ira M Hall
Author Affiliation
McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO 63108, USA; Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Genetics, Yale University School of Medicine, New Haven, CT 06510, USA.
Source
Am J Hum Genet. 2021 04 01; 108(4):583-596
Date
04-01-2021
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Alleles
Cardiovascular Diseases - genetics
Cholesterol - blood
DNA Copy Number Variations - genetics
Female
Finland
Genome, Human - genetics
Genomic Structural Variation - genetics
Genotype
High-Throughput Nucleotide Sequencing
Humans
Male
Mitochondrial Proteins - genetics
Promoter Regions, Genetic - genetics
Pyruvate Dehydrogenase (Lipoamide)-Phosphatase - genetics
Pyruvic Acid - metabolism
Serum Albumin, Human - genetics
Abstract
The contribution of genome structural variation (SV) to quantitative traits associated with cardiometabolic diseases remains largely unknown. Here, we present the results of a study examining genetic association between SVs and cardiometabolic traits in the Finnish population. We used sensitive methods to identify and genotype 129,166 high-confidence SVs from deep whole-genome sequencing (WGS) data of 4,848 individuals. We tested the 64,572 common and low-frequency SVs for association with 116 quantitative traits and tested candidate associations using exome sequencing and array genotype data from an additional 15,205 individuals. We discovered 31 genome-wide significant associations at 15 loci, including 2 loci at which SVs have strong phenotypic effects: (1) a deletion of the ALB promoter that is greatly enriched in the Finnish population and causes decreased serum albumin level in carriers (p = 1.47 × 10-54) and is also associated with increased levels of total cholesterol (p = 1.22 × 10-28) and 14 additional cholesterol-related traits, and (2) a multi-allelic copy number variant (CNV) at PDPR that is strongly associated with pyruvate (p = 4.81 × 10-21) and alanine (p = 6.14 × 10-12) levels and resides within a structurally complex genomic region that has accumulated many rearrangements over evolutionary time. We also confirmed six previously reported associations, including five led by stronger signals in single nucleotide variants (SNVs) and one linking recurrent HP gene deletion and cholesterol levels (p = 6.24 × 10-10), which was also found to be strongly associated with increased glycoprotein level (p = 3.53 × 10-35). Our study confirms that integrating SVs in trait-mapping studies will expand our knowledge of genetic factors underlying disease risk.
PubMed ID
33798444 View in PubMed
Less detail

Bayesian age-period-cohort models with versatile interactions and long-term predictions: mortality and population in Finland 1878-2050.

https://arctichealth.org/en/permalink/ahliterature259147
Source
Stat Med. 2014 Feb 28;33(5):845-56
Publication Type
Article
Date
Feb-28-2014
Author
Aki S Havulinna
Source
Stat Med. 2014 Feb 28;33(5):845-56
Date
Feb-28-2014
Language
English
Publication Type
Article
Keywords
Bayes Theorem
Cohort Studies
Female
Finland
Forecasting
Humans
Male
Models, Statistical
Population Dynamics
Stochastic Processes
Abstract
Age-period-cohort (APC) models are widely used for studying time trends of disease incidence or mortality. Model identifiability has become less of a problem with Bayesian APC models. These models are usually based on random walk (RW1, RW2) smoothing priors. For long and complex time series and for long predicted periods, these models as such may not be adequate. We present two extensions for the APC models. First, we introduce flexible interactions between the age, period and cohort effects based on a two-dimensional conditional autoregressive smoothing prior on the age/period plane. Our second extension uses autoregressive integrated (ARI) models to provide reasonable long-term predictions. To illustrate the utility of our model framework, we provide stochastic predictions for the Finnish male and female population, in 2010-2050. For that, we first study and forecast all-cause male and female mortality in Finland, 1878-2050, showing that using an interaction term is needed for fitting and interpreting the observed data. We then provide population predictions using a cohort component model, which also requires predictions for fertility and migration. As our main conclusion, ARI models have better properties for predictions than the simple RW models do, but mixing these prediction models with RW1 or RW2 smoothing priors for observed periods leads to a model that is not fully consistent. Further research with our model framework will concentrate on using a more consistent model for smoothing and prediction, such as autoregressive integrated moving average models with state-space methods or Gaussian process priors.
PubMed ID
24105769 View in PubMed
Less detail

Biomarker profiling by nuclear magnetic resonance spectroscopy for the prediction of all-cause mortality: an observational study of 17,345 persons.

https://arctichealth.org/en/permalink/ahliterature256800
Source
PLoS Med. 2014 Feb;11(2):e1001606
Publication Type
Article
Date
Feb-2014
Author
Krista Fischer
Johannes Kettunen
Peter Würtz
Toomas Haller
Aki S Havulinna
Antti J Kangas
Pasi Soininen
Tõnu Esko
Mari-Liis Tammesoo
Reedik Mägi
Steven Smit
Aarno Palotie
Samuli Ripatti
Veikko Salomaa
Mika Ala-Korpela
Markus Perola
Andres Metspalu
Author Affiliation
The Estonian Genome Center, University of Tartu, Tartu, Estonia.
Source
PLoS Med. 2014 Feb;11(2):e1001606
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Biological Markers - blood
Biological Specimen Banks
Cause of Death
Citric Acid - blood
Estonia - epidemiology
Female
Finland - epidemiology
High-Throughput Screening Assays - methods
Humans
Kaplan-Meier Estimate
Lipoproteins, LDL - blood
Magnetic Resonance Spectroscopy
Male
Middle Aged
Orosomucoid - analysis
Particle Size
Predictive value of tests
Prognosis
Proportional Hazards Models
Reproducibility of Results
Risk assessment
Risk factors
Serum Albumin - analysis
Time Factors
Young Adult
Abstract
Early identification of ambulatory persons at high short-term risk of death could benefit targeted prevention. To identify biomarkers for all-cause mortality and enhance risk prediction, we conducted high-throughput profiling of blood specimens in two large population-based cohorts.
106 candidate biomarkers were quantified by nuclear magnetic resonance spectroscopy of non-fasting plasma samples from a random subset of the Estonian Biobank (n?=?9,842; age range 18-103 y; 508 deaths during a median of 5.4 y of follow-up). Biomarkers for all-cause mortality were examined using stepwise proportional hazards models. Significant biomarkers were validated and incremental predictive utility assessed in a population-based cohort from Finland (n?=?7,503; 176 deaths during 5 y of follow-up). Four circulating biomarkers predicted the risk of all-cause mortality among participants from the Estonian Biobank after adjusting for conventional risk factors: alpha-1-acid glycoprotein (hazard ratio [HR] 1.67 per 1-standard deviation increment, 95% CI 1.53-1.82, p?=?5×10?³¹), albumin (HR 0.70, 95% CI 0.65-0.76, p?=?2×10?¹8), very-low-density lipoprotein particle size (HR 0.69, 95% CI 0.62-0.77, p?=?3×10?¹²), and citrate (HR 1.33, 95% CI 1.21-1.45, p?=?5×10?¹°). All four biomarkers were predictive of cardiovascular mortality, as well as death from cancer and other nonvascular diseases. One in five participants in the Estonian Biobank cohort with a biomarker summary score within the highest percentile died during the first year of follow-up, indicating prominent systemic reflections of frailty. The biomarker associations all replicated in the Finnish validation cohort. Including the four biomarkers in a risk prediction score improved risk assessment for 5-y mortality (increase in C-statistics 0.031, p?=?0.01; continuous reclassification improvement 26.3%, p?=?0.001).
Biomarker associations with cardiovascular, nonvascular, and cancer mortality suggest novel systemic connectivities across seemingly disparate morbidities. The biomarker profiling improved prediction of the short-term risk of death from all causes above established risk factors. Further investigations are needed to clarify the biological mechanisms and the utility of these biomarkers for guiding screening and prevention.
Notes
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PubMed ID
24586121 View in PubMed
Less detail

A blood pressure genetic risk score is a significant predictor of incident cardiovascular events in 32,669 individuals.

https://arctichealth.org/en/permalink/ahliterature115422
Source
Hypertension. 2013 May;61(5):987-94
Publication Type
Article
Date
May-2013
Author
Aki S Havulinna
Johannes Kettunen
Olavi Ukkola
Clive Osmond
Johan G Eriksson
Y Antero Kesäniemi
Antti Jula
Leena Peltonen
Kimmo Kontula
Veikko Salomaa
Christopher Newton-Cheh
Author Affiliation
Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
Source
Hypertension. 2013 May;61(5):987-94
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Blood Pressure - genetics
Cardiovascular Diseases - epidemiology - ethnology - genetics
Cohort Studies
Cross-Sectional Studies
Female
Finland - epidemiology
Follow-Up Studies
Genome-Wide Association Study
Genotype
Humans
Hypertension - genetics
Incidence
Longitudinal Studies
Male
Middle Aged
Polymorphism, Single Nucleotide - genetics
Prospective Studies
Retrospective Studies
Risk factors
Abstract
Recent genome-wide association studies have identified genetic variants associated with blood pressure (BP). We investigated whether genetic risk scores (GRSs) constructed of these variants would predict incident cardiovascular disease (CVD) events. We genotyped 32 common single nucleotide polymorphisms in several Finnish cohorts, with up to 32,669 individuals after exclusion of prevalent CVD cases. The median follow-up was 9.8 years, during which 2295 incident CVD events occurred. We created GRSs separately for systolic BP and diastolic BP by multiplying the risk allele count of each single nucleotide polymorphism by the effect size estimated in published genome-wide association studies. We performed Cox regression analyses with and without adjustment for clinical factors, including BP at baseline in each cohort. The results were combined by inverse variance-weighted fixed-effects meta-analysis. The GRSs were strongly associated with systolic BP and diastolic BP, and baseline hypertension (all P
Notes
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Comment In: Hypertension. 2013 May;61(5):961-323509079
PubMed ID
23509078 View in PubMed
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Calcium:magnesium ratio in local groundwater and incidence of acute myocardial infarction among males in rural Finland.

https://arctichealth.org/en/permalink/ahliterature169425
Source
Environ Health Perspect. 2006 May;114(5):730-4
Publication Type
Article
Date
May-2006
Author
Anne Kousa
Aki S Havulinna
Elena Moltchanova
Olli Taskinen
Maria Nikkarinen
Johan Eriksson
Marjatta Karvonen
Author Affiliation
Geological Survey of Finland, Kuopio, Finland. anne.kousa@gtk.fi
Source
Environ Health Perspect. 2006 May;114(5):730-4
Date
May-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Calcium - analysis
Finland - epidemiology
Humans
Incidence
Magnesium - analysis
Male
Middle Aged
Myocardial Infarction - epidemiology
Rural Population
Water - analysis
Abstract
Several epidemiologic studies have shown an association between calcium and magnesium and coronary heart disease mortality and morbidity. In this small-area study, we examined the relationship between acute myocardial infarction (AMI) risk and content of Ca, Mg, and chromium in local groundwater in Finnish rural areas using Bayesian modeling and geospatial data aggregated into 10 km times symbol 10 km grid cells. Data on 14,495 men 35-74 years of age with their first AMI in the years 1983, 1988, or 1993 were pooled. Geochemical data consisted of 4,300 measurements of each element in local groundwater. The median concentrations of Mg, Ca, and Cr and the Ca:Mg ratio in well water were 2.61 mg/L, 12.23 mg/L, 0.27 microg/L, and 5.39, respectively. Each 1 mg/L increment in Mg level decreased the AMI risk by 4.9%, whereas a one unit increment in the Ca:Mg ratio increased the risk by 3.1%. Ca and Cr did not show any statistically significant effect on the incidence and spatial variation of AMI. Results of this study with specific Bayesian statistical analysis support earlier findings of a protective role of Mg and low Ca:Mg ratio against coronary heart disease but do not support the earlier hypothesis of a protective role of Ca.
Notes
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PubMed ID
16675428 View in PubMed
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