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Article ; Online: Risk Factors for Ischemic Stroke After Acute Coronary Syndrome.

Hurskainen, Matilda / Tynkkynen, Juho / Eskola, Markku / Lehtimäki, Terho / Hernesniemi, Jussi

Journal of the American Heart Association

2023 Volume 12, Issue 14, Page(s) e028787

Abstract: Background Stroke incidence is elevated after acute coronary syndromes (ACS). The aim of this study was to characterize risk factors related to ischemic stroke (IS) after ACS. Methods and Results We conducted a retrospective registry study based on the ... ...

Abstract	Background Stroke incidence is elevated after acute coronary syndromes (ACS). The aim of this study was to characterize risk factors related to ischemic stroke (IS) after ACS. Methods and Results We conducted a retrospective registry study based on the data of 8049 consecutive patients treated for ACS between 2007 and 2018 in Tays Heart Hospital with a follow-up until December 31, 2020. Potential risk factors were identified by in-depth review of written hospital records and causes-of-death registry data maintained by Statistics Finland. The association between individual risk factors, early-onset IS (0-30 days after ACS, n=82), and late-onset IS (31 days to 14 years after ACS, n=419) were analyzed using logistic regression and subdistribution hazard analysis. In multivariable analysis, the most substantial risk factors for early- and late-onset IS were previous stroke, atrial fibrillation or flutter, and heart failure status depicted by the Killip classification. Left ventricular ejection fraction and coronary artery disease severity were significant risk factors for early-onset IS; age and peripheral artery disease were significant risk factors for late-onset IS. The risk of early-onset IS with ≥6 CHA
MeSH term(s)	Humans ; Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/epidemiology ; Acute Coronary Syndrome/complications ; Ischemic Stroke/complications ; Retrospective Studies ; Stroke Volume ; Ventricular Function, Left ; Risk Factors ; Stroke/diagnosis ; Stroke/epidemiology ; Stroke/etiology ; Atrial Fibrillation/epidemiology ; Risk Assessment/methods
Language	English
Publishing date	2023-07-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.122.028787
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Book ; Thesis: Apolipoprotein E phenotypes in Finnish children and young adults

Lehtimäki, Terho

(Acta Universitatis Tamperensis : Ser. A ; 340)

1992

Author's details	Terho Lehtimäki
Series title	Acta Universitatis Tamperensis : Ser. A ; 340 Acta Universitatis Tamperensis Acta Universitatis Tamperensis ; Ser. A
Collection	Acta Universitatis Tamperensis Acta Universitatis Tamperensis ; Ser. A
Keywords	Finnland ; Kind ; Apolipoprotein E ; Polymorphismus ; Epidemiologie ; Jugend ; Koronare Herzkrankheit ; Risikofaktor
Subject	Risikofaktoren ; Herzkranzgefäßleiden ; Koronararterie ; Herzkranzgefäßkrankheit ; Coronary artery disease ; Polymorphie ; Heteromorphie ; Pleomorphie ; APOE ; Krankheitsverbreitung ; Jugend ; Jugendalter ; Jugendlicher ; Teenager ; Kindheit ; Kindesalter ; Kindschaft ; Kinder
Size	Getr. Zählung : Ill., graph. Darst.
Publisher	Univ. of Tampere
Publishing place	Tampere
Publishing country	Finland
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Tampere, Univ., Diss., 1992
HBZ-ID	HT004331707
ISBN	951-44-3131-6 ; 978-951-44-3131-9
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Article ; Online: Temporal variability of serum miR-191, miR-223, miR-128, and miR-24 in multiple sclerosis: A 4-year follow-up study.

Vistbakka, Julia / Sumelahti, Marja-Liisa / Lehtimäki, Terho / Hagman, Sanna

Journal of the neurological sciences

2022 Volume 442, Page(s) 120395

Abstract: Background: Circulating microRNAs (miRNA) are suggested to be a promising biomarker for multiple sclerosis (MS). Previously, miR-128-3p, miR-24-3p, miR-191-5p and miR-223-3p have been reported to associate with MS pathology. However, their longitudinal ... ...

Abstract	Background: Circulating microRNAs (miRNA) are suggested to be a promising biomarker for multiple sclerosis (MS). Previously, miR-128-3p, miR-24-3p, miR-191-5p and miR-223-3p have been reported to associate with MS pathology. However, their longitudinal changes and association with the disease activity have not been studied. Objectives: To evaluate the serum temporal variability of miR-128-3p, miR-191-5p, miR-24-3p, and miR-223-3p and their association with disability and disease activity in MS. Methods: The expression of four miRNAs in serum was studied in 57 MS patients, 18 clinically isolated syndrome patients, and 32 healthy controls over the four-year follow-up. Results: At the baseline, miR-191-5p was overexpressed in RRMS in comparison to controls, and its levels correlated positively with EDSS and progression index (PI) in RRMS. Increased levels of miR-128-3p were detected in PPMS in comparison to controls, and increased levels correlated with EDSS and PI in RRMS. The expression of miR-24-3p and miR-223-3p did not differ between the subtypes, but miR-223-3p correlated negatively with T1 lesions volumes in SPMS and PPMS. Over the four-years follow-up period, the expression of miR-128-3p and miR-24-3p was stable longitudinally, while temporal changes of miR-191-5p and miR-223-3p were observed in MS. Temporal changes in miR-191-5p were observed to be associated with an increase of EDSS or MRI activity, while the variability of miR-223-3p was associated with relapses. Conclusion: Temporal variability of miR-191-5p and miR-223-3p are associated with changes in disability accumulation and disease activity. While, miR-128-3p was stably expressed and associated with the PPMS subtype and correlated with disability accumulation.
MeSH term(s)	Humans ; Multiple Sclerosis/genetics ; Follow-Up Studies ; MicroRNAs ; Biomarkers ; Magnetic Resonance Imaging
Chemical Substances	MicroRNAs ; Biomarkers ; MIRN128 microRNA, human ; MIRN191 microRNA, human ; MIRN223 microRNA, human ; MIRN24 microRNA, human
Language	English
Publishing date	2022-08-30
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80160-4
ISSN	1878-5883 ; 0022-510X ; 0374-8642
ISSN (online)	1878-5883
ISSN	0022-510X ; 0374-8642
DOI	10.1016/j.jns.2022.120395
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Article ; Online: The association between GRACE score at admission for myocardial infarction and the incidence of sudden cardiac arrests in long-term follow-up - the MADDEC study.

Hautamäki, Markus / Järvensivu-Koivunen, Minna / Lyytikäinen, Leo-Pekka / Eskola, Markku / Lehtimäki, Terho / Nikus, Kjell / Oksala, Niku / Tynkkynen, Juho / Hernesniemi, Jussi

Scandinavian cardiovascular journal : SCJ

2024 Volume 58, Issue 1, Page(s) 2335905

Abstract: Background. ...

Abstract	Background.
MeSH term(s)	Humans ; Follow-Up Studies ; Incidence ; Retrospective Studies ; Risk Factors ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/prevention & control ; Death, Sudden, Cardiac/etiology ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Myocardial Infarction/therapy ; Heart Arrest ; Defibrillators, Implantable ; Hospitalization
Language	English
Publishing date	2024-04-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1379906-x
ISSN	1651-2006 ; 1401-7431
ISSN (online)	1651-2006
ISSN	1401-7431
DOI	10.1080/14017431.2024.2335905
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Article ; Online: Effect of weight on depression using multiple genetic instruments.

Viinikainen, Jutta / Böckerman, Petri / Willage, Barton / Elovainio, Marko / Kari, Jaana T / Lehtimäki, Terho / Pehkonen, Jaakko / Pitkänen, Niina / Raitakari, Olli

PloS one

2024 Volume 19, Issue 2, Page(s) e0297594

Abstract: A striking global health development over the past few decades has been the increasing prevalence of overweight and obesity. At the same time, depression has become increasingly common in almost all high-income countries. We investigated whether body ... ...

Abstract	A striking global health development over the past few decades has been the increasing prevalence of overweight and obesity. At the same time, depression has become increasingly common in almost all high-income countries. We investigated whether body weight, measured by body mass index (BMI), has a causal effect on depression symptoms in Finland. Using data drawn from the Cardiovascular Risk in Young Finns Study (N = 1,523, mean age 41.9, SD 5), we used linear regression to establish the relationship between BMI and depression symptoms measured by 21-item Beck's Depression Inventory. To identify causal relationships, we used the Mendelian randomization (MR) method with weighted sums of genetic markers (single nucleotide polymorphisms, SNPs) as instruments for BMI. We employ instruments (polygenic risk scores, PGSs) with varying number of SNPs that are associated with BMI to evaluate the sensitivity of our results to instrument strength. Based on linear regressions, higher BMI was associated with a higher prevalence of depression symptoms among females (b = 0.238, p = 0.000) and males (b = 0.117, p = 0.019). However, the MR results imply that the positive link applies only to females (b = 0.302, p = 0.007) but not to males (b = -0.070, p = 0.520). Poor instrument strength may explain why many previous studies that have utilized genetic instruments have been unable to identify a statistically significant link between BMI and depression-related traits. Although the number of genetic markers in the instrument had only a minor effect on the point estimates, the standard errors were much smaller when more powerful instruments were employed.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Body Mass Index ; Depression/epidemiology ; Depression/genetics ; Genetic Markers ; Genome-Wide Association Study ; Mendelian Randomization Analysis ; Obesity/epidemiology ; Obesity/genetics ; Overweight/epidemiology ; Overweight/genetics ; Polymorphism, Single Nucleotide ; Middle Aged
Chemical Substances	Genetic Markers
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0297594
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Article ; Online: Association of childhood socioeconomic status with adulthood maximal exercise blood pressure: the Cardiovascular Risk in Young Finns Study.

Kähönen, Erika / Kähönen, Emilia / Pälve, Kristiina / Hulkkonen, Janne / Kähönen, Mika / Raitakari, Olli T / Hutri, Nina / Lehtimäki, Terho / Aatola, Heikki

Blood pressure

2024 Volume 33, Issue 1, Page(s) 2323987

Abstract: Purpose: Socioeconomic status has been related to resting blood pressure (BP) levels at different stages of life. However, the association of childhood socioeconomic status (SES) and adulthood exercise BP is largely unknown. Therefore, we studied the ... ...

Abstract	Purpose: Socioeconomic status has been related to resting blood pressure (BP) levels at different stages of life. However, the association of childhood socioeconomic status (SES) and adulthood exercise BP is largely unknown. Therefore, we studied the association of childhood SES with adulthood maximal exercise BP. Materials and methods: This investigation consisted of 373 individuals (53% women) participating in the Cardiovascular Risk in Young Finns Study who had data concerning family SES in childhood (baseline in 1980, at age of 6-18 years) and exercise BP response data in adulthood (follow-up in adulthood in 27-29 years since baseline). A maximal cardiopulmonary exercise test with BP measurements was performed by participants, and peak exercise BP was measured. Results: In stepwise multivariable analysis including childhood risk factors and lifestyle factors (body mass index, systolic BP, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, fruit consumption, vegetable consumption, and physical activity), lower family SES in childhood was associated with higher maximal exercise BP in adulthood (β value ± SE, 1.63 ± 0.77, Conclusions: These findings suggest that lower childhood family SES is associated with higher maximal exercise BP in adulthood.
MeSH term(s)	Humans ; Female ; Child ; Adolescent ; Male ; Risk Factors ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Blood Pressure ; Finland ; Social Class ; Heart Disease Risk Factors ; Exercise ; Hypertension ; Cholesterol
Chemical Substances	Cholesterol (97C5T2UQ7J)
Language	English
Publishing date	2024-03-11
Publishing country	England
Document type	Journal Article
ZDB-ID	1170048-8
ISSN	1651-1999 ; 1651-2480 ; 0803-7051 ; 0803-8023
ISSN (online)	1651-1999 ; 1651-2480
ISSN	0803-7051 ; 0803-8023
DOI	10.1080/08037051.2024.2323987
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Article ; Online: Sex differences in coronary atherosclerosis during the pre- and postmenopausal period: The Tampere Sudden Death Study.

Hakamaa, Emma / Goebeler, Sirkka / Martiskainen, Mika / Louhelainen, Anne-Mari / Ahinko, Katja / Lehtimäki, Terho / Karhunen, Pekka

Atherosclerosis

2024 Volume 390, Page(s) 117459

Abstract: Background and aims: Women are believed to be protected from coronary heart disease (CHD) by the effects of estrogen but detailed studies on the vessel wall level are missing. We aimed to measure sex differences in atherosclerosis during the ... ...

Abstract	Background and aims: Women are believed to be protected from coronary heart disease (CHD) by the effects of estrogen but detailed studies on the vessel wall level are missing. We aimed to measure sex differences in atherosclerosis during the premenopausal and postmenopausal periods directly at the coronary arteries. Methods: We analyzed statistics for sex differences in CHD mortality in Finland in 2020. Coronary atherosclerosis was measured using computer-assisted morphometry in 10-year age groups of 185 white Caucasian women and 515 men from the Tampere Sudden Death Study. Results: CHD mortality was rare in both women and men before 50 years of age. After 50 years of age, male mortality increased rapidly, with women reaching equal levels in the oldest age groups. In the autopsy series, there were no differences in fatty streak, fibrotic or calcified plaque areas, nor in the plaque area or stenosis percentage in coronary arteries between premenopausal women and men in the same age group. The plaque area remained 25 % smaller in both coronaries in postmenopausal women aged 51-70 years compared to men. In the oldest postmenopausal group (≥70 years), plaque area reached the level of men. In the postmenopausal period, coronary stenosis in the left anterior descending (LAD) artery remained lower among women. Conclusion: We did not detect any major sex-difference in coronary atherosclerosis in the premenopausal period when women are considered to be protected from CHD. However, in line with CHD mortality statistics, postmenopausal women showed a slower speed of coronary atherosclerosis development compared to men.
MeSH term(s)	Female ; Male ; Humans ; Middle Aged ; Coronary Artery Disease/epidemiology ; Postmenopause ; Sex Characteristics ; Atherosclerosis ; Plaque, Atherosclerotic ; Death, Sudden
Language	English
Publishing date	2024-01-24
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	80061-2
ISSN	1879-1484 ; 0021-9150
ISSN (online)	1879-1484
ISSN	0021-9150
DOI	10.1016/j.atherosclerosis.2024.117459
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Article ; Online: Trajectories of cardiovascular risk predict pregnancy outcomes: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study.

Harville, Emily W / Hakala, Juuso O / Rovio, Suvi P / Pahkala, Katja / Raitakari, Olli / Lehtimäki, Terho

Paediatric and perinatal epidemiology

2023 Volume 38, Issue 3, Page(s) 168–179

Abstract: Background: Life course patterns of change in risk-trajectories-affect health.: Objectives: To examine how trajectories of cardiovascular risk factors are associated with pregnancy and birth outcomes.: Methods: Data from two cohort studies ... ...

Abstract	Background: Life course patterns of change in risk-trajectories-affect health. Objectives: To examine how trajectories of cardiovascular risk factors are associated with pregnancy and birth outcomes. Methods: Data from two cohort studies participating in the International Childhood Cardiovascular Consortium-The Bogalusa Heart Study (BHS; started in 1973, N = 903 for this analysis) and the Cardiovascular Risk in Young Finns Study (YFS; started in 1980, N = 499) were used. Both followed children into adulthood and measured cardiovascular risk factors, including body mass index (BMI), systolic and diastolic blood pressure (SBP/DBP), total, lipoprotein (LDL)- and high density lipoprotein (HDL)-cholesterol and serum triglycerides. Discrete mixture modelling was used to divide each cohort into distinct trajectories according to these risk factors from childhood to early adulthood, and these groups were then used to predict pregnancy outcomes including small for gestational age (SGA; <10th study-specific percentile of gestational age by sex), preterm birth (PTB; <37 weeks' gestation), hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), with control for age at baseline and at first birth, parity, socioeconomic status, BMI and smoking. Results: The models created more trajectories for BMI, SBP and HDL-cholesterol in the YFS than in BHS, for which three classes generally seemed to be sufficient to represent the groups in the population across risk factors. In BHS, the association between the higher and flatter DBP trajectory and PTB was aRR 1.77, 95% confidence interval [CI] 1.06, 2.96. In BHS the association between consistent total cholesterol and PTB was aRR 2.16, 95% CI 1.22, 3.85 and in YFS the association between elevated high trajectory and PTB was aRR 3.35, 95% CI 1.28, 8.79. Elevated-increasing SBP was associated with a higher risk of GH in BHS and increasing or persistent-obese BMI trajectories were associated with GDM in both cohorts (BHS: aRR 3.51, 95% CI 1.95, 6.30; YFS: aRR 2.61, 95% CI 0.96, 7.08). Conclusions: Trajectories of cardiovascular risk, particularly those that represent a consistent or more rapid worsening of cardiovascular health, are associated with a higher risk of pregnancy complications.
MeSH term(s)	Pregnancy ; Child ; Female ; Infant, Newborn ; Humans ; Risk Factors ; Cardiovascular Diseases/etiology ; Finland ; Premature Birth/epidemiology ; Diabetes, Gestational ; Longitudinal Studies ; Heart Disease Risk Factors ; Cholesterol
Chemical Substances	Cholesterol (97C5T2UQ7J)
Language	English
Publishing date	2023-07-11
Publishing country	England
Document type	Journal Article
ZDB-ID	639089-4
ISSN	1365-3016 ; 0269-5022 ; 1353-663X
ISSN (online)	1365-3016
ISSN	0269-5022 ; 1353-663X
DOI	10.1111/ppe.12995
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Article ; Online: Accumulation of Lewy-Related Pathology Starts in Middle Age: The Tampere Sudden Death Study.

Kok, Eloise H / Paetau, Anders / Martiskainen, Mika / Lyytikäinen, Leo-Pekka / Lehtimäki, Terho / Karhunen, Pekka / Myllykangas, Liisa

Annals of neurology

2024

Abstract: When effective treatments against neurodegenerative diseases become a reality, it will be important to know the age these pathologies begin to develop. We investigated alpha-synuclein pathology in brain tissue of the Tampere Sudden Death Study-unselected ...

Abstract	When effective treatments against neurodegenerative diseases become a reality, it will be important to know the age these pathologies begin to develop. We investigated alpha-synuclein pathology in brain tissue of the Tampere Sudden Death Study-unselected forensic autopsies on individuals living outside hospital institutions in Finland. Of 562 (16-95 years) participants, 42 were positive for Lewy-related pathology (LRP). The youngest LRP case was aged 54 years, and the frequency of LRP in individuals aged ≥50 years was 9%. This forensic autopsy study indicates LRP starts already in middle age and is more common than expected in the ≥50 years-of-age non-hospitalized population. ANN NEUROL 2024.
Language	English
Publishing date	2024-03-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	80362-5
ISSN	1531-8249 ; 0364-5134
ISSN (online)	1531-8249
ISSN	0364-5134
DOI	10.1002/ana.26912
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Article ; Online: Polymorphisms in

Puolakka, Hanna / Solismaa, Anssi / Lyytikäinen, Leo-Pekka / Viikki, Merja / Seppälä, Niko / Mononen, Nina / Lehtimäki, Terho / Kampman, Olli

Acta neuropsychiatrica

2024 , Page(s) 1–19

Abstract: Objective: Sialorrhea is a common and uncomfortable adverse effect of clozapine, and its severity varies between patients. The aim of the study was to select broadly genes related to the regulation of salivation and study associations between sialorrhea ...

Abstract	Objective: Sialorrhea is a common and uncomfortable adverse effect of clozapine, and its severity varies between patients. The aim of the study was to select broadly genes related to the regulation of salivation and study associations between sialorrhea and dry mouth and polymorphisms in the selected genes. Methods: The study population consists of 237 clozapine-treated patients, of which 172 were genotyped. Associations between sialorrhea and dry mouth with age, sex, BMI, smoking, clozapine dose, clozapine and norclozapine serum levels, and other comedication were studied. Genetic associations were analyzed with linear and logistic regression models explaining sialorrhea and dry mouth with each SNP added separately to the model as coefficients. Results: Clozapine dose, clozapine or norclozapine concentration and their ratio were not associated with sialorrhea or dryness of mouth. Valproate use (p=0.013) and use of other antipsychotics (p=0.015) combined with clozapine were associated with excessive salivation. No associations were found between studied polymorphisms and sialorrhea. In analyses explaining dry mouth with logistic regression with age and sex as coefficients, two proxy-SNPs were associated with dry mouth: Conclusion: Use of valproate or antipsychotic polypharmacy may increase the risk of sialorrhea. Genetic variations in
Language	English
Publishing date	2024-04-18
Publishing country	England
Document type	Journal Article
ZDB-ID	1154361-9
ISSN	1601-5215 ; 0924-2708
ISSN (online)	1601-5215
ISSN	0924-2708
DOI	10.1017/neu.2024.9
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