Diseases and quality of care – Cardiovascular diseases

Repeated procedures after balloon angioplasty and bypass surgery

Urgent repeat procedures within seven days after balloon angioplasty or bypass surgery are relatively rare.

During one year of follow-up, the proportion of repeat procedures after balloon angioplasty typically ranged between approximately 5–12 percent across hospitals. After bypass surgery, repeat procedures were clearly less common, performed in an average of 2.1 percent of patients. Over a follow-up period of 1–3 years, the rate of repeat procedures after balloon angioplasty was 3–8 percent, whereas after bypass surgery the corresponding rate averaged 1.8 percent.

The data are based on the Cardiac Registry, which is part of the national quality registries. The Cardiac Registry’s indicator on repeat procedures following balloon angioplasty and bypass surgery was published in spring 2026.

“However, when interpreting the results, it should be noted that the analyses have not been able to adjust for all significant factors. For example, differences in patients’ clinical situations and treatment practices, as well as the implementation of risk factor management, may explain the observed hospital-level differences,” says Markku Eskola, Chief Physician at the Heart Hospital.

Percutaneous Coronary Intervention and bypass surgery are an essential part of cardiac care

Coronary artery disease is classified into severity categories based on factors such as the number and location of narrowed arteries. The choice of treatment is based on an individualized assessment, in which medication is often the primary and best treatment option for the patient.  

However, medication alone is not sufficient for all patients, in which case invasive treatments, such as Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Grafting (CABG) may be considered.

According to an indicator published in 2025, three out of four patients with severe (three-vessel) chronic coronary artery disease undergo either PCI or CABG in addition to medical treatment.

Treatment guidelines steer patient care

For patients with diabetes, bypass surgery is generally recommended for three-vessel disease as it improves the patient’s prognosis more than PCI.  

When examining patients who have undergone either PCI or CABG, it is evident that diabetic patients with severe coronary artery disease more often undergo bypass surgery. These findings suggest that diabetes influences treatment selection but also raise the question of whether the strong emphasis on diabetes in treatment guidelines is fully reflected in clinical practice.

Treatment decisions are always influenced by many factors beyond diabetes, particularly when surgical risks are evaluated. The indicator reflects only completed interventions, not the decision-making processes behind them. Further development will improve assessment of guideline adherence.

Adherence to cholesterol-lowering medication is associated with lower mortality among heart attack patients

Coronary artery disease is a condition whose progression can be slowed through lifestyle changes and medication. High-quality care and measures that prevent recurrent Myocardial Infarctions (MI) can reduce mortality and improve patients’ functional capacity.

In patients with coronary artery disease, discontinuing cholesterol-lowering medication or adhering to the treatment regimen only partially reduces the effectiveness of treatment and increases the risk of serious cardiac events. The data is based on the Cardiac Register, one of THL’s national clinical quality registries.

The results clearly demonstrate the importance of regular and long-term adherence to cholesterol-lowering medication. A clear association can be seen between medication adherence and mortality.

Diseases of the circulatory system, including Coronary Artery Disease (CAD), remain the most common cause of death in Finland. The average age of people diagnosed with coronary artery disease has risen, and the number of myocardial infarctions has decreased in the 2020s. However, coronary artery disease remains a common and serious condition.

Managing cholesterol levels and especially achieving the target level of LDL cholesterol is an essential part of the treatment of patients with coronary artery disease. Treatment often continues for life, requiring long-term commitment even if lowered cholesterol levels cannot be directly felt in patient’s own wellbeing.

Adherence to cholesterol treatment declines during a two-year follow-up

The Cardiac Register produces follow-up data on patients treated with Percutaneous Coronary Intervention (PCI) after a myocardial infarction. One of the indicators published by the Cardiac Registry shows how well these patients adhere to their cholesterol-lowering treatment.

Patients adhere very well during the first year after PCI. When looking at the national average, 92.2 percent of patients treated with PCI were adherent to their cholesterol medication after one year. Adherence varied across wellbeing services counties, ranging from 87 percent in Kainuu to 95.1 percent in Central Finland.  

However, the use of cholesterol medication has been observed to decrease clearly as the follow‑up period lengthens. In the two‑year follow‑up, adherence to the medication declined noticeably in all wellbeing regions, with the national average dropping to about 85 percent.

These results highlight the importance of long-term follow-up and support for adherence so that cholesterol treatment continues as recommended. 

 

About the data in more detail

Go to the Cardiac Register report (in Finnish)

Reported quality indicators

• Incidence
• Mortality
• LDL cholesterol values at 1 and 2 years
• Implementation of cholesterol-lowering treatment
• Implementation of coronary interventions according to guidelines
• Repeat procedures after PCI and CABG (upcoming)

Background information

• Data description (Data resources catalogue) (in Finnish)
• Privacy notice (in Finnish)

Source

Heart Register Results Report. THL.
Report updated 7 May 2026. Data includes information up to 31 Dec 2025.

Statistical description

The Cardiac Registry provides systematic and standardized data on how patients with coronary artery disease are treated nationwide and regionally in Finland. The registry collects data on both patients who have suffered a heart attack and those with chronic coronary artery disease. The data provided by the Cardiac Registry can be used to improve the quality and effectiveness of care for patients with coronary artery disease.  

The Cardiac Registry contains data on an estimated 277,000 patients with coronary artery disease from the wellbeing services counties of mainland Finland. Results are reported at the wellbeing services county or hospital level, depending on the indicator. 

In the regional results, the Uusimaa counties (Eastern Uusimaa, Central Uusimaa, Western Uusimaa, Vantaa-Kerava) and Helsinki have been combined into a single region (Uusimaa), as the HUS Group coordinates specialized medical care for heart attack patients in that region.

The data presented in the report are based on the Cardiac Registry, which is part of the Finnish Institute for Health and Welfare’s (THL) national quality registries.  

Update schedule

The register report is published annually in April_May.