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    Angiotensin receptor neprilysin inhibitor for patients with heart failure and reduced ejection fraction: Real-world experience from Turkey (ARNi-TR)
    (Turkish Soc Cardiology, 2021) Ekici, Berkay; Yaman, Mehmet; Kucuk, Murathan; Dereli, Seckin; Yenercag, Mustafa; Yigit, Zerrin; Bas, Mehmet Memduh
    Objective: Heart failure (HF) is a growing public health problem with high morbidity and mortality. Recently, angiotensin receptor neprilysin inhibitor (ARNi) has emerged as a promising treatment for HF with reduced ejection fraction (HFrEF). Here, we shared our experience with the use of ARNi in HFrEF from multiple centers in Turkey. Methods: The ARNi-TR is a multicenter, nonintervention al, retrospective, observational study. Overall, 779 patients with HF from 22 centers in Turkey who were prescribed sacubitril/valsartan were examined. Initial clinical status, biochemical and echocardiographic parameters, and New York Heart Association functional class (NYHA-FC) values were compared with follow-up values after 1 year of ARNi use. In addition, the effect of ARNi on number of annual hospitalizations was investigated, and the patients were divided into 2 groups, depending on whether ARNi was initiated at hospitalization or under outpatient clinic control. Results: N-terminal pro-brain natriuretic peptide (NT-proBNP), left-ventricle ejection fraction (LV-EF), and NYHA-FC values improved significantly in both groups (all parameters, p<0.001) within 1-year follow-up. In both groups, a decrease in hemoglobin A1c (HbA1c) values was observed in ARNi use (p<0.001), and a decrease in daily diuretic doses and hospitalizations owing to HF were observed after ARNi use (all comparisons, p<0.001). Hypotension (16.9%) was the most common side effect in patients using ARNi. Conclusion: The ARNi-TR study offers comprehensive real-life data for patients using ARNi in Turkey. The use of ARNi has shown significant improvements in FC, NT-proBNP, HbA1c levels, and LV-EF. Likewise, reductions in the number of annual hospitalizations and daily furosemide doses for HF were seen in this study.
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    FREQUENCY OF CARDIOVASCULAR DISEASES AND DRUG USE IN TURKISH ELDERLY POPULATION FOLLOWED UP AT CARDIOLOGY CLINICS: THE ELDERTURK STUDY
    (Gunes Kitabevi Ltd Sti, 2017) Zoghi, Mehdi; Ozyuncu, Nil; Ozal, Ender; Cakmak, Huseyin Altug; Yayla, Cagri; Icli, Atilla; Ozyildiz, Ali Gokhan; Oncel, Can Ramazan; Akboga, Mehmet Kadri; Kose, Nuri; Kucuk, Murathan; Tokgozoglu, Lale
    Introduction: In Turkey, there is a lack of data on the frequency of cardiovascular diseases, risk factors, co-morbid diseases, and drug usage among the elderly population. We aimed to compile a data of frequency of cardiovascular diseases, cardiovascular risk factors, concomitant diseases, and drug usage among elderly patients visiting cardiology clinics in Turkey. Materials and Method: This non-interventional, multicenter study evaluated 5694 patients aged 65 years or older and who were followed up at cardiology clinics. Cardiovascular diseases, risk factors, co-morbidities, and medication use were surveyed. Results: Mean age of patients was 73.5 similar to 6.3 years (males: 49.8%). The frequency rates were 73% for hypertension, 28.8% for diabetes mellitus, 35% for hyperlipidemia, 50% for previous myocardial infarction, 27.3% for atrial fibrillation, and 11.5% for chronic renal failure. The body mass index of participants was 27.7 +/- 4.4 kg/m2, systolic blood pressure was 130 +/- 18 mmHg, diastolic blood pressure was 77.1 +/- 11 mmHg, and resting heart rate was 6 +/- 14 bpm, 66.3% of the study population used beta blockers, 71.7% angiotensin system inhibitors, 59.6% diuretics, 7.9% digoxin, 30.5% calcium channel blockers, 34% lipid-lowering agents, 71.5% acetylsalicylic acid, and 25.9% oral anticoagulants. The most common non-cardiovascular medications were vitamins (12.3%) and nonsteroidal anti-inflammatory drugs (11.2%). Conclusion: Valuable data of Turkey's elderly population at cardiology clinics, pertaining to cardiovascular and co-morbid diseases was collected. The identification of risk factors for cardiovascular diseases as well as concomitant diseases, and medication use in elderly patients may lead to interventions that could improve the health of elderly in the general population.
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    Patient Perception, Knowledge and Adaptation in The Management of Heart Failure: A Multicenter, CrossSectional, Observational, Questionnaire-Based Study: ADAPTATION HF
    (Kare Publ, 2024) Murat, Selda; Cavusoglu, Yuksel; Yilmaz, Mehmet Birhan; Yildirimtuerk, Ozlem; Ulvan, Nedret; Celik, Ahmet; Kucuk, Murathan
    Objective: The aim of this study is to reveal the perception levels of heart failure (HF) patients about the disease, their adaptation to the disease process, their compliance with the treatment, and their knowledge and thoughts about the disease from the patient's perspective. Method: Patients with a diagnosis of HF for at least 6 months who applied to the cardiology clinics of 10 different centers were included in this cross-sectional, multicenter and questionnaire-based study. A questionnaire consisting of sections that included demographic information, evaluation of the patient's symptoms, knowledge and experience of clinical follow-up, knowledge of HF, compliance and awareness of treatment was applied to the patients. Results: 504 patients with a mean age of 59.8 +/- 14.9 years (M/F: 360/144, 71.4%/28.6%) were included in the study. 61.2% of the patients stated that they knew about HF disease before. Most of the patients knew that the complaints of shortness of breath, fatigue and palpitation could develop due to HF (95.4%; 92.7%; 89.7%, respectively). The patients reported that they were mostly worried about not being able to provide their own self-care without the support of another person (67.5%). While the majority of patients (37.6%) thought that the worst disease was to have a cerebrovascular disease; only 10.9% stated that HF was the worst disease. While 98.8% of the patients stated that they used HF drugs regularly, a relatively large part of the patients did not know that the drugs were effective on kidney functions (68.5%) and blood pressure (76.9%). In the daily practice of the patients, the rate of weight follow-up was 35.5%, the rate of blood pressure monitoring was 26.9%, and the rate of patients who exercised was 27%. Among the patients, 73.3% said that they pay attention to the amount of salt they take with diet, and 33.5% have a completely salt.free diet. There was no difference between the groups with low and high knowledge scores in terms of Pittsburgh Sleep Quality Index (P > 0.005). The knowledge level score was significantly higher in patients with previous myocardial infarction (P = 0.002). Conclusion: Most of the HF patients participating in the study are aware of the signs and symptoms of HF, follow the recommendations of their physicians, and use drugs regularly. These patients should have more information about blood pressure monitoring, weight monitoring, diet and sodium restriction, exercise, which are included in the non -pharmacological part of treatment management.