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Tiivistelmä Nikotiini on riippuvuutta aiheuttava, terveydelle haitallinen yhdiste. Se lisää monin tavoin sairastuvuutta ja kuolleisuutta sydän- ja verisuonitauteihin. Se aiheuttaa useilla mekanismeilla endoteelin toiminnan häiriöitä, ja sen sykettä tihentävä sekä verenpainetta nostava vaikutus välittyy sympaattisen hermoston aktivaation kautta. Nikotiini aktivoi reniini-angiotensiinijärjestelmää (RAS), jonka toiminnan häiriö liittyy moniin sydän- ja verisuonitauteihin. Nikotiini vaikuttaa hengitystä säätelevään kemorefleksiin. Nuorena alkanut nikotiinin käyttö kuormittaa sydän- ja verenkiertoelimistöä, ja pitkäaikaisvaikutukset kertautuvat aikuisiällä. Yhteiskunnan tulisi panostaa nikotiinittomuuteen ja kohdistaa toimet erityisesti nuoriin.

Aims: To evaluate risk factors for major adverse cardiac event (MACE) after the first acute coronary syndrome (ACS) and to examine the prevalence of risk factors in post-ACS patients. Methods: We used Finnish population-based myocardial infarction register, FINAMI, data from years 1993–2011 to identify survivors of first ACS (n = 12686), who were then followed up for recurrent events and all-cause mortality for three years. Finnish FINRISK risk factor surveys were used to determine the prevalence of risk factors (smoking, hyperlipidaemia, diabetes and blood pressure) in post-ACS patients (n = 199). Results: Of the first ACS survivors, 48.4% had MACE within three years of their primary event, 17.0% were fatal. Diabetes (p = 4.4 × 10−7), heart failure (HF) during the first ACS attack hospitalization (p = 6.8 × 10−15), higher Charlson index (p = 1.56 × 10−19) and older age (p = .026) were associated with elevated risk for MACE in the three-year follow-up, and revascularization (p = .0036) was associated with reduced risk. Risk factor analyses showed that 23% of ACS survivors continued smoking and cholesterol levels were still high (>5mmol/l) in 24% although 86% of the patients were taking lipid lowering medication. Conclusion: Diabetes, higher Charlson index and HF are the most important risk factors of MACE after the first ACS. Cardiovascular risk factor levels were still high among survivors of first ACS.

Background: In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary E