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Background: An increasing volume of evidence suggests that haemostatic factors play a role in the risk of coronary heart disease. It is not known, however, whether between-population differences in haemostatic factors correspond with the differences in mortality related to coronary heart disease. We examined this question in Finland, where, in North Karelia (in the eastern part of the country), the mortality from coronary heart disease is 1.5-1.7 times higher than that in southwestern areas., Methods: A random sample of 3000 people aged 45-64 years was drawn from the population registers of North Karelia, of the area surrounding Turku and Loimaa in southwestern Finland and of the Helsinki area in southern Finland. Of the 3000 people approached, 79.6% took part in the study. differences in coronary heart disease mortality and morbidity., Results: Factor-VII coagulant activity was significantly higher in North Karelia than in the other areas (P = 0.0008). The fibrinogen level was also higher in North Karelia, although the difference was significant only among non-smokers (P = 0.02). Levels of factor-VII antigen, plasminogen and lipoprotein (a) did not differ between the areas. Within North Karelia, the levels of both factor-VII coagulant activity, and factor-VII antigen were higher in rural areas than in urban areas. Levels of factor-VII coagulant activity, factor-VII antigen and plasminogen were higher in women than in men and increased with age in women but not in men. The fibrinogen level increased with age in both sexes., Conclusion: These baseline findings of the Finrisk Haemostasis Study demonstrate that the geographical differences in levels of factor-VII coagulant activity and fibrinogen in Finland are consistent with the population

Heparin rebound has been suggested to occur when protamine sulfate, but not protamine chloride, is used to neutralize heparin. This study was undertaken to compare these two protamine salts in 32 patients undergoing coronary artery bypass surgery. Initial heparin and subsequent protamine doses were determined by constructing a heparin-activated coagulation time response curve. Heparin was neutralized either with protamine sulfate or protamine chloride. The total protamine/heparin dose ratio was 0.71 +/- 0.05 for protamine sulfate and 0.77 +/- 0.07 (mg/100 U) for protamine chloride. The initial neutralization effect, the subsequent behavior of the plasma heparin level, and the various coagulation parameters did not differ significantly between the groups. Two hours after neutralization, a small and temporary increase of plasma heparin level was observed in both groups. The postoperative blood losses were comparable in both groups. Thus, protamine chloride was not a clinically superior antidote to heparin than protamine sulfate. The observed heparin rebound levels were low and clinically insignificant in terms of blood loss, but they were associated with slight changes in coagulation monitoring.

Known risk factors for coronary heart disease do not explain all of the clinical and epidemiological features of the disease. To examine the role of chronic bacterial infections as risk factors for the disease the association between poor dental health and acute myocardial infarction was investigated in two separate case-control studies of a total of 100 patients with acute myocardial infarction and 102 controls selected from the community at random. Dental health was graded by using two indexes, one of which was assessed blind. Based on these indexes dental health was significantly worse in patients with acute myocardial infarction than in controls. The association remained valid after adjustment for age, social class, smoking, serum lipid concentrations, and the presence of diabetes. Further prospective studies are required in different populations to confirm the association and to elucidate its nature.