OBJECTIVES: To investigate changes in the medical treatment of patients with myocardial infarction and the trends in revascularization procedures in Finland. DESIGN: A population-based myocardial infarction (MI) register study. SETTING: Populations, aged 25-64 years, of the three geographical areas of Finland, provinces of North Karelia and Kuopio in eastern Finland and the Turku-Loimaa area in south-western Finland. MAIN OUTCOME MEASURES: Medical treatment administered prior to the coronary event, during the hospitalization and at discharge from hospital to all patients hospitalized due to suspected myocardial infarction and all CAD deaths occurring during three separate 4-month periods in 1986, 1989 and 1992. Data on coronary bypass surgery and percutaneous coronary angioplasty in the study areas for 1986-92. RESULTS: The most marked change in the medical treatment of hospitalized myocardial infarction patients was the significant increase in the use of thrombolytic treatment (5% of patients in 1986 and 24% in 1992, P < 0.001 for trend). The use of antiplatelet agents increased from 1986 to 1992 prior to the coronary event, during the hospitalization and at discharge. The use of beta-blockers and intravenous nitrates increased and the use of calcium-channel blockers declined significantly in hospitalized patients during the study period. Hospitalized male myocardial infarction patients were treated more often with beta-blockers, nitrates, antiplatelet agents and thrombolytic agents than female patients, suggesting less intensive medical treatment in women. CONCLUSION: The results of the large clinical trials regarding the medical treatment of myocardial infarction patients were adopted in the clinical practice rapidly and the treatment of myocardial infarction patients and the number of revascularization procedures changed markedly from 1986 to 1992 in Finland. These changes may in part explain the favourable changes in mortality from CAD in Finland.
OBJECTIVES: To investigate changes in the medical treatment of patients with myocardial infarction and the trends in revascularization procedures in Finland. DESIGN: A population-based myocardial infarction (MI) register study. SETTING: Populations, aged 25-64 years, of the three geographical areas of Finland, provinces of North Karelia and Kuopio in eastern Finland and the Turku-Loimaa area in south-western Finland. MAIN OUTCOME MEASURES: Medical treatment administered prior to the coronary event, during the hospitalization and at discharge from hospital to all patients hospitalized due to suspected myocardial infarction and all CAD deaths occurring during three separate 4-month periods in 1986, 1989 and 1992. Data on coronary bypass surgery and percutaneous coronary angioplasty in the study areas for 1986-92. RESULTS: The most marked change in the medical treatment of hospitalized myocardial infarctionpatients was the significant increase in the use of thrombolytic treatment (5% of patients in 1986 and 24% in 1992, P < 0.001 for trend). The use of antiplatelet agents increased from 1986 to 1992 prior to the coronary event, during the hospitalization and at discharge. The use of beta-blockers and intravenous nitrates increased and the use of calcium-channel blockers declined significantly in hospitalized patients during the study period. Hospitalized male myocardial infarctionpatients were treated more often with beta-blockers, nitrates, antiplatelet agents and thrombolytic agents than female patients, suggesting less intensive medical treatment in women. CONCLUSION: The results of the large clinical trials regarding the medical treatment of myocardial infarctionpatients were adopted in the clinical practice rapidly and the treatment of myocardial infarctionpatients and the number of revascularization procedures changed markedly from 1986 to 1992 in Finland. These changes may in part explain the favourable changes in mortality from CAD in Finland.
Authors: V Salomaa; H Miettinen; M Niemelä; M Ketonen; M Mähönen; P Immonen-Räihä; S Lehto; T Vuorenmaa; S Koskinen; P Palomäki; H Mustaniemi; E Kaarsalo; M Arstila; J Torppa; K Kuulasmaa; P Puska; K Pyörälä; J Tuomilehto Journal: J Epidemiol Community Health Date: 2001-07 Impact factor: 3.710
Authors: Hanna-Riikka Lehto; Seppo Lehto; Aki S Havulinna; Matti Ketonen; Aapo Lehtonen; Y Antero Kesäniemi; Juhani Airaksinen; Veikko Salomaa Journal: BMC Cardiovasc Disord Date: 2007-11-12 Impact factor: 2.298