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57 records – page 1 of 6.

The ability of an electrocardiogram to predict fatal and non-fatal cardiac events in asymptomatic middle-aged subjects.

https://arctichealth.org/en/permalink/ahliterature283977
Source
Ann Med. 2016 Nov;48(7):525-531
Publication Type
Article
Date
Nov-2016
Author
Henri K Terho
Jani T Tikkanen
Tuomas V Kenttä
M Juhani Junttila
Aapo L Aro
Olli Anttonen
Tuomas Kerola
Harri A Rissanen
Paul Knekt
Antti Reunanen
Heikki V Huikuri
Source
Ann Med. 2016 Nov;48(7):525-531
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Adult
Cardiovascular Diseases - mortality - physiopathology
Electrocardiography - methods
Female
Finland
Humans
Male
Middle Aged
Predictive value of tests
Prognosis
Registries
Risk factors
Abstract
The long-term prognostic value of a standard 12-lead electrocardiogram (ECG) for predicting cardiac events in apparently healthy middle-aged subjects is not well defined.
A total of 9511 middle-aged subjects (mean age 43?±?8.2 years, 52% males) without a known cardiac disease and with a follow-up 40 years were included in the study. Fatal and non-fatal cardiac events were collected from the national registries. The predictive value of ECG was separately analyzed for 10 and 30 years. Major ECG abnormalities were classified according to the Minnesota code.
Subjects with major ECG abnormalities (N?=?1131) had an increased risk of cardiac death after 10-years (adjusted hazard ratio [HR] 1.7; 95% confidence interval [95% CI], 1.1-2.5, p?=?0.009) and 30-years of follow-up (HR 1.3, 95% CI, 1.1-1.5, p?
PubMed ID
27684209 View in PubMed
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Airway obstruction and the risk of myocardial infarction and death from coronary heart disease: a national health examination survey with a 33-year follow-up period.

https://arctichealth.org/en/permalink/ahliterature297762
Source
Eur J Epidemiol. 2018 01; 33(1):89-98
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2018
Author
Tiina Mattila
Tuula Vasankari
Harri Rissanen
Paul Knekt
Pauli Puukka
Markku Heliövaara
Author Affiliation
Heart and Lung Center, Helsinki University Hospital, Meilahti Triangle Hospital, HUS, 6th Floor, PO Box 372, 00029, Helsinki, Finland. tiina.m.mattila@fimnet.fi.
Source
Eur J Epidemiol. 2018 01; 33(1):89-98
Date
01-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Airway Obstruction - epidemiology
Cause of Death
Coronary Disease - mortality
Female
Finland - epidemiology
Follow-Up Studies
Health Surveys
Hospitalization
Humans
Male
Middle Aged
Myocardial Infarction - mortality
Proportional Hazards Models
Risk factors
Abstract
Chronic obstructive pulmonary disease (COPD) has been associated with coronary mortality. Yet, data about the association between COPD and acute myocardial infarction (MI) remain scarce. We aimed to study airway obstruction as a predictor of MI and coronary mortality among 5576 Finnish adults who participated in a national health examination survey between 1978 and 1980. Subjects underwent spirometry, had all necessary data, showed no indications of cardiovascular disease at baseline, and were followed up through record linkage with national registers through 2011. The primary outcome consisted of a major coronary event-that is, hospitalization for MI or coronary death, whichever occurred first. We specified obstruction using the lower limit of normal categorization. Through multivariate analysis adjusted for potential confounding factors for coronary heart disease, hazard ratios (HRs) (with the 95% confidence intervals in parentheses) of a major coronary event, MI, and coronary death reached 1.06 (0.79-1.42), 0.84 (0.54-1.31), and 1.40 (1.04-1.88), respectively, in those with obstruction compared to others. However, in women aged 30-49 obstruction appeared to predict a major coronary event, where the adjusted HR reached 4.21 (1.73-10.28). In conclusion, obstruction appears to predict a major coronary event in younger women only, whereas obstruction closely associates with the risk of coronary death independent of sex and age.
PubMed ID
28688065 View in PubMed
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Antibodies to periodontal pathogens and stroke risk.

https://arctichealth.org/en/permalink/ahliterature179360
Source
Stroke. 2004 Sep;35(9):2020-3
Publication Type
Article
Date
Sep-2004
Author
Pirkko J Pussinen
Georg Alfthan
Harri Rissanen
Antti Reunanen
Sirkka Asikainen
Paul Knekt
Author Affiliation
Institute of Dentistry, University of Helsinki, P.O. Box 63 (Haartmaninkatu 8), FIN-00014 Helsinki, Finland. pirkko.pussinen@helsinki.fi
Source
Stroke. 2004 Sep;35(9):2020-3
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Aggregatibacter actinomycetemcomitans - immunology
Antibodies, Bacterial - blood - immunology
Antibody Specificity
Case-Control Studies
Comorbidity
Coronary Disease - epidemiology - immunology
Diabetes Mellitus - epidemiology
Enzyme-Linked Immunosorbent Assay
Female
Finland - epidemiology
Humans
Hypertension - epidemiology
Immunoglobulin A - blood - immunology
Immunoglobulin G - blood - immunology
Male
Middle Aged
Periodontitis - immunology - microbiology
Porphyromonas gingivalis - immunology
Risk
Stroke - epidemiology - immunology
Abstract
The association between cerebrovascular events and periodontitis has been found in few studies based on clinical periodontal examinations. However, evidence on the association between periodontal pathogens and stroke is lacking. Therefore, the aim of the study was to investigate whether elevated levels of serum antibodies to major periodontal pathogens predict stroke in a case-control study.
The study population comprised 6950 subjects (aged 45 to 64 years) who participated in the Mobile Clinic Health Survey in 1973 to 1976 in Finland. During a follow-up of 13 years, a total of 173 subjects had a stroke. From these, 64 subjects had already experienced a stroke or had signs of coronary heart disease (CHD) at baseline, whereas 109 subjects were apparently healthy. Two controls per case were matched for age, gender, municipality, and disease status. Serum IgG and IgA class antibody levels to the periodontal pathogens, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis, were determined by multiserotype enzyme-linked immunosorbent assay.
The cases identified during the follow-up that were free of stroke or CHD at baseline were more often IgA-seropositive for A. actinomycetemcomitans than were their controls, 41.3% versus 29.3%. Compared with the seronegative, the seropositive subjects had a multivariate odds ratio of 1.6 (95% CI, 1.0 to 2.6) for stroke. The patients with a history of stroke or CHD at baseline were more often IgA-seropositive for P. gingivalis than were their controls, 79.7% versus 70.2%. When compared with the seronegative, the seropositive subjects had an odds ratio of 2.6 (1.0 to 7.0) for secondary stroke.
The present prospective study provides serological evidence that an infection caused by major periodontal pathogens is associated with future stroke.
PubMed ID
15232116 View in PubMed
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Association between all-cause and cause-specific mortality and the GOLD stages 1-4: A 30-year follow-up among Finnish adults.

https://arctichealth.org/en/permalink/ahliterature272552
Source
Respir Med. 2015 Aug;109(8):1012-8
Publication Type
Article
Date
Aug-2015
Author
Tiina Mattila
Tuula Vasankari
Merja Kanervisto
Tarja Laitinen
Olli Impivaara
Harri Rissanen
Paul Knekt
Pekka Jousilahti
Seppo Saarelainen
Pauli Puukka
Markku Heliövaara
Source
Respir Med. 2015 Aug;109(8):1012-8
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Adult
Cause of Death - trends
Female
Finland - epidemiology
Follow-Up Studies
Forced expiratory volume
Forecasting
Humans
Male
Population Surveillance - methods
Proportional Hazards Models
Pulmonary Disease, Chronic Obstructive - mortality - physiopathology
Retrospective Studies
Risk Assessment - methods
Risk factors
Severity of Illness Index
Survival Rate - trends
Vital Capacity
Abstract
Mortality correlates with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria of airway obstruction. Yet, little data exist concerning the long-term survival of patients presenting with different levels of obstruction.
We studied the association between all-cause and cause-specific mortality and GOLD stages 1-4 in a 30-year follow-up among 6636 Finnish men and women aged 30 or older participating in the Mini-Finland Health Study between 1978 and 1980.
After adjusting for age, sex, and smoking history, the GOLD stage of the subject showed a strong direct relationship with all-cause mortality, mortality from cardiovascular and respiratory diseases, and cancer. The adjusted hazard ratios of death were 1.27 (95% confidence interval (CI) 1.06-1.51), 1.40 (1.21-1.63), 1.55 (1.21-1.97) and 2.85 (1.65-4.94) for GOLD stages 1-4, respectively, with FEV1/FVC =70% as the reference. The association between GOLD stages 2-4 and mortality was strongest among subjects under 50 years of age at the baseline measurement. Cardiovascular mortality increased consistently for all GOLD stages.
Airway obstruction indicates an increased risk for all-cause mortality according to the severity of the GOLD stage. We found that even stage 1 carries a risk for cardiovascular death independently of smoking history and other known risk factors.
PubMed ID
26108990 View in PubMed
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Association of Helicobacter pylori IgA antibodies with the risk of peptic ulcer disease and gastric cancer.

https://arctichealth.org/en/permalink/ahliterature171090
Source
World J Gastroenterol. 2005 Nov 21;11(43):6871-4
Publication Type
Article
Date
Nov-21-2005
Author
Timo U Kosunen
Kari Seppala
Seppo Sarna
Arpo Aromaa
Paul Knekt
Jarmo Virtamo
Anniina Salomaa-Rasanen
Hilpi Rautelin
Author Affiliation
Department of Bacteriology and Immunology, University of Helsinki, PO Box 21, FIN-00014 Helsinki, Finland. timo.kosunen@helsinki.fi
Source
World J Gastroenterol. 2005 Nov 21;11(43):6871-4
Date
Nov-21-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antibodies, Bacterial - blood
Antigens, Bacterial - immunology
Finland
Helicobacter Infections - immunology
Helicobacter pylori - immunology
Humans
Immunoglobulin A - blood
Immunoglobulin G - immunology
Middle Aged
Peptic Ulcer - immunology - microbiology
Risk factors
Stomach Neoplasms - immunology - microbiology
Abstract
To compare the prevalence of Helicobacter pylori (H pylori) IgG and IgA antibodies between adult subjects, with defined gastric diseases, non-defined gastric disorders and those representing the population.
Data on H pylori IgG and IgA antibodies, determined by enzyme immunoassay, were analyzed in 3,252 subjects with DGD including 482 patients with gastric ulcer, 882 patients with duodenal ulcer, 1,525 patients with chronic gastritis only and 363 subjects with subsequent gastric cancer, 19,145 patients with NoDg and 4,854 POPUL subjects. The age-adjusted prevalences were calculated for 1- and 20-year age cohorts.
The prevalences of IgG antibodies were equally high (89-96%) in all 20-year age cohorts of the DGD groups, whereas the prevalences of IgG antibodies were lower and increased by age in the POPUL and NoDg groups. The prevalences of IgA antibodies were also higher in the DGD groups; among them CA (84-89%) and GU groups (78-91%) showed significantly higher prevalences than DU (68-77%) and CG patients (59-74%) (OR 2.49, 95%CI 1.86-3.34 between the GU and DU groups). In the CA, GU, and DU groups, the IgA prevalences showed only minor variation according to age, while they increased by age in the CG, POPUL, and NoDg groups (P
PubMed ID
16425400 View in PubMed
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Body Mass Index as a Predictor of Sudden Cardiac Death and Usefulness of the Electrocardiogram for Risk Stratification.

https://arctichealth.org/en/permalink/ahliterature272891
Source
Am J Cardiol. 2016 Feb 1;117(3):388-93
Publication Type
Article
Date
Feb-1-2016
Author
Antti Eranti
Aapo L Aro
Tuomas Kerola
Jani T Tikkanen
Harri A Rissanen
Olli Anttonen
M Juhani Junttila
Paul Knekt
Heikki V Huikuri
Source
Am J Cardiol. 2016 Feb 1;117(3):388-93
Date
Feb-1-2016
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Coronary Artery Disease - complications - mortality - physiopathology
Death, Sudden, Cardiac - epidemiology - etiology
Electrocardiography
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Obesity - complications - physiopathology
Predictive value of tests
Proportional Hazards Models
Risk Assessment - methods
Risk factors
Survival Rate - trends
Abstract
Evidence of the role of body mass index (BMI) as a risk factor for sudden cardiac death (SCD) is conflicting, and how electrocardiographic (ECG) SCD risk markers perform in subjects with different BMIs is not known. In this study, a general population cohort consisting of 10,543 middle-aged subjects (mean age 44 years, 52.7% men) was divided into groups of lean (BMI 30, n = 1,445) subjects. Cox proportional hazards models adjusted for confounders were used to assess the risk for SCD associated with BMI and the risk for SCD associated with ECG abnormalities in subjects with different BMIs. The overweight and obese subjects were at increased risk for SCD (hazard ratios [95% CIs] were 1.33 [1.13 to 1.56], p = 0.001 and 1.79 [1.44 to 2.23], p
PubMed ID
26723105 View in PubMed
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Cohort Profile: The Finnish Mobile Clinic Health Surveys FMC, FMCF and MFS.

https://arctichealth.org/en/permalink/ahliterature296694
Source
Int J Epidemiol. 2017 12 01; 46(6):1760-1761i
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-01-2017

Consumption of sweetened beverages and intakes of fructose and glucose predict type 2 diabetes occurrence.

https://arctichealth.org/en/permalink/ahliterature163474
Source
J Nutr. 2007 Jun;137(6):1447-54
Publication Type
Article
Date
Jun-2007
Author
Jukka Montonen
Ritva Järvinen
Paul Knekt
Markku Heliövaara
Antti Reunanen
Author Affiliation
National Public Health Institute, Helsinki FIN, Finland. jukka.montonen@ktl.fi
Source
J Nutr. 2007 Jun;137(6):1447-54
Date
Jun-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Beverages
Cohort Studies
Diabetes Mellitus, Type 2 - chemically induced - epidemiology
Diet Surveys
Energy intake
Female
Finland - epidemiology
Fructose - administration & dosage - adverse effects
Glucose - administration & dosage - adverse effects
Humans
Incidence
Male
Middle Aged
Questionnaires
Abstract
The role of intakes of different sugars in the development of type 2 diabetes was studied in a cohort of 4,304 men and women aged 40-60 y and initially free of diabetes at baseline in 1967-1972. Food consumption data were collected using a dietary history interview covering the habitual diet during the previous year. The intakes of different sugars were calculated and divided in quartiles. During a 12-y follow-up, 177 incidents of type 2 diabetes cases were identified from a nationwide register. Combined intake of fructose and glucose was associated with the risk of type 2 diabetes but no significant association was observed for intakes of sucrose, lactose, or maltose. The relative risk between the highest and lowest quartiles of combined fructose and glucose intake was 1.87 (95% [CI] = 1.19, 2.93; P = 0.003). The corresponding relative risks between the extreme quartiles of consumption of food items contributing to sugar intakes were 1.69 (95% [CI] = 1.17, 2.43; P
Notes
Comment In: J Nutr. 2008 Jan;138(1):138; author reply 13918156416
PubMed ID
17513405 View in PubMed
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The cost-effectiveness of short-term psychodynamic psychotherapy and solution-focused therapy in the treatment of depressive and anxiety disorders during a one-year follow-up.

https://arctichealth.org/en/permalink/ahliterature124220
Source
J Ment Health Policy Econ. 2012 Mar;15(1):13-23
Publication Type
Article
Date
Mar-2012
Author
Timo Maljanen
Paivi Paltta
Tommi Harkanen
Esa Virtala
Olavi Lindfors
Maarit A Laaksonen
Paul Knekt
Author Affiliation
Social Insurance Institution, PO Box 450, 00101 Helsinki, Finland. timo.maljanen@kela.fi
Source
J Ment Health Policy Econ. 2012 Mar;15(1):13-23
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Anxiety Disorders - economics - epidemiology - therapy
Behavior Therapy - economics
Combined Modality Therapy
Cost of Illness
Cost-Benefit Analysis
Cross-Sectional Studies
Depressive Disorder, Major - economics - epidemiology - therapy
Female
Finland
Humans
Male
Problem Solving
Psychoanalytic Therapy - economics
Psychotherapy, Brief - economics
Transference (Psychology)
Abstract
Mood and anxiety disorders are characterized by a high and increasing prevalence, they cause a lot of costs and human suffering and there are many treatment options with differing costs. The benefits of identifying the treatments with the most favourable cost-effectiveness ratios can be substantial. However, the number of randomized trials where psychological treatments are compared with each other and where economic aspects, too, are taken into account is still relatively small.
To compare the cost-effectiveness of two short-term psychotherapies in the treatment of depressive and anxiety disorders during a one-year follow-up.
In the Helsinki Psychotherapy Study, 198 patients, who were 20--45 years of age and met DSM-IV criteria for anxiety or mood disorder, were randomized to short-term psychodynamic psychotherapy (SPP) or solution-focused therapy (SFT). Psychiatric symptoms were assessed at baseline and 4 times during the one-year follow-up from the start of therapy using the Beck Depression Inventory and the Symptom Check List Anxiety Scale, and 2 times using the Hamilton Depression Rating Scales and Hamilton Anxiety Rating Scales. Both direct costs (therapy sessions, outpatient visits, medication, inpatient care) and indirect costs (production losses due to work absenteeism, value of neglected household work, lost leisure time and unpaid help received) due to mental disorders were measured. Mean total costs were compared and incremental cost-effectiveness ratios analyzed.
According to all 4 psychiatric outcome measures, symptoms of depression and anxiety were reduced statistically significantly in both therapy groups during the one-year follow-up. The relative changes were about the same size according to all four outcome measures. In both groups the reductions took place mainly in the first half of the follow-up. The reductions were somewhat greater with SPP, but the differences between the two groups were small and not statistically significant at any measurement point. The mean total direct costs were 1791 euros in the SPP group, being 346 euros (16%) lower than those of the SFT group, but this difference was not statistically significant either. Also the incremental cost-effectiveness ratio points calculated by 500 bootstrap iterations favoured SPP. The total indirect costs in the SPP group were, in contrast to direct costs, higher than those in the SFT group, but, again, the difference was not statistically significant.
The generalization of our results may be weakened by the fact that the patients included in our study were relatively young, and the follow-up period was restricted to one year.
This study suggests that there are no notable differences in cost-effectiveness between SPP and SFT. If one were obliged to choose between these two therapies our results would support the choice of SPP. However, more research with extensive data about both costs and effectiveness, compiled over a period longer than one year, are needed before any firm conclusions can be drawn about the cost-effectiveness of the two therapies compared in this study.
PubMed ID
22611089 View in PubMed
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Delayed QRS transition in the precordial leads of an electrocardiogram as a predictor of sudden cardiac death in the general population.

https://arctichealth.org/en/permalink/ahliterature265592
Source
Heart Rhythm. 2014 Dec;11(12):2254-60
Publication Type
Article
Date
Dec-2014
Author
Aapo L Aro
Antti Eranti
Olli Anttonen
Tuomas Kerola
Harri A Rissanen
Paul Knekt
Kimmo Porthan
Jani T Tikkanen
M Juhani Junttila
Heikki V Huikuri
Source
Heart Rhythm. 2014 Dec;11(12):2254-60
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Arrhythmias, Cardiac - diagnosis - mortality
Cause of Death
Death, Sudden, Cardiac - epidemiology
Electrocardiography - methods
Female
Finland - epidemiology
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Population Surveillance
Predictive value of tests
Proportional Hazards Models
Retrospective Studies
Risk assessment
Sex Distribution
Time Factors
Abstract
QRS transition zone is related to the electrical axis of the heart in the horizontal plane and is easily determined from the precordial leads of a standard 12-lead ECG. However, whether delayed QRS transition, or clockwise rotation of the heart, carries prognostic implications and predicts sudden cardiac death (SCD) is unclear.
The purpose of this study was to study whether delayed transition is associated with mortality and SCD.
We evaluated 12-lead ECGs of 10,815 Finnish middle-aged subjects from the general population (52% men, mean age 44 ± 8.5 years) and followed them for 30 ± 11 years. Main end-points were mortality and SCD.
Delayed QRS transition at lead V4 or later occurred in 1770 subjects (16.4%) and markedly delayed transition at lead V5 or later in 146 subjects (1.3%). Delayed transition zone was associated with older age, male gender, higher body mass index, hypertension, baseline cardiovascular disease, leftward shift of the frontal QRS axis, wider QRS-T angle, and ECG left ventricular hypertrophy. After adjusting for several clinical and ECG variables, delayed transition was associated with overall mortality (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.07-1.22, P
PubMed ID
25131180 View in PubMed
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57 records – page 1 of 6.