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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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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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Tuberculosis, Airway Obstruction and Mortality in a Finnish Population.

https://arctichealth.org/en/permalink/ahliterature287304
Source
COPD. 2017 Apr;14(2):143-149
Publication Type
Article
Date
Apr-2017
Author
Tiina Mattila
Markku Heliövaara
Harri Rissanen
Paul Knekt
Pauli Puukka
Tuula Vasankari
Source
COPD. 2017 Apr;14(2):143-149
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Airway Obstruction - diagnostic imaging - epidemiology
Female
Finland - epidemiology
Follow-Up Studies
Health Surveys
Humans
Male
Middle Aged
Mortality
Odds Ratio
Radiography, Thoracic
Severity of Illness Index
Spirometry
Tuberculosis, Pulmonary - diagnostic imaging - epidemiology
Abstract
There is little long-term follow-up data concerning the association between past pulmonary tuberculosis (TB), airway obstruction and mortality. We aimed to analyse a national health examination survey data from 6701 adult Finns undergoing spirometry between 1978 and 1980 (follow-up through 2013). We identified TB either through a disease history or by a TB-indicative scar on a chest x-ray. We specified obstruction using the lower limit of normal (LLN) and classified severity using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages 1-4. After adjusting for smoking and other confounders, past TB associated with obstruction. Compared to non-TB patients, the adjusted odds ratio (OR; 95% CI) of obstruction reached 2.21 (1.52-3.21) among patients with a scar recorded by one radiologist, 2.48 (1.63-3.78) when recorded by both radiologists and 4.59 (2.86-7.37) among patients with a disease history. Among those with neither past TB nor obstruction, with past TB only, with an obstruction only and with both, we found hazard ratios (HRs; 95% CIs) for subsequent mortality of 1.00 (reference), 1.11 (1.03-1.20), 1.62 (1.31-2.00) and 1.77 (1.45-2.16), adjusted for age, gender, smoking, body mass index (BMI), physical activity, education and general health. In conclusion, past TB strongly determines obstruction, although on its own quite weakly predicts premature death. TB and obstruction combined predict an additive mortality pattern.
PubMed ID
27880044 View in PubMed
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