Long-Term Prognosis after Acute Coronary Syndrome and Risk Factors for Recurrent Event.

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Oulu University Hospital, LS 8

Topic of the dissertation

Long-Term Prognosis after Acute Coronary Syndrome and Risk Factors for Recurrent Event.

Doctoral candidate

Licentiate of Medicine Marjo Okkonen

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, the Medical Research Center

Subject of study

Medicine

Opponent

Professor Pirjo Mustonen, The wellbeing services county of Southwest Finland (Varha)

Custos

Professor Olavi Ukkola, University of Oulu

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Long-Term Prognosis after Acute Coronary Syndrome and Risk Factors for Recurrent Event

Cardiovascular diseases are the leading cause of death in Finland. Coronary heart disease is the main group of cardiovascular diseases and 22,000 people are hospitalized in Finland every year because of acute coronary syndrome. The risk factors and long-term prognosis of coronary heart disease should be studied to assess the impact coronary heart disease has on public economy and on the health of the population.

In the first publication of this thesis, the long-term prognosis of acute coronary syndrome was studied between the years 1993–2011. The study population was drawn from the FINAMI register and it included patients who had survived 28 days after their first ever acute coronary syndrome event. The results were then compared to a healthy population drawn from the FINRISK population surveys of the same areas and of the same age as the FINAMI study patients. In the third publication of this thesis, risk factors for recurrent events after the first acute coronary syndrome event were evaluated. The purpose of the second publication of this thesis was to study the validity of ST-elevation myocardial infarction and non-ST-elevation myocardial infarction diagnoses in the Finnish hospital discharge register.

The results showed that even though the prognosis of acute coronary syndrome had improved during the years 1993–2012 it was still worse than the prognosis of a general population sample drawn from the FINRISK participants. Almost 25% of the first acute coronary syndrome survivors had a recurrent event within the first year after the primary event and 37% had a recurrence within three years. Especially diabetes and heart failure during the index event were risk factors for a recurrence. The subtypes of acute coronary syndrome (ST-elevation myocardial infarction and non-ST-elevation myocardial infarction) could not be used in scientific research as such because the validity of these diagnoses in the Finnish hospital discharge register was poor.

It is extremely important to understand the trends in diseases and the impact of treatments on diseases to target the limited funds and resources of health care so that the patients and professionals obtain the maximum benefit. This is especially important now that Finnish health care is in great transition.
Last updated: 1.9.2023