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    Snapshot evaluation of heart failure in Turkey: Baseline characteristics of SELFIE-TR
    (Turkish Soc Cardiology, 2019) Yilmaz, Mehmet Birhan; Celik, Ahmet; Cavusoglu, Yuksel; Bekar, Lutfu; Onrat, Ersel; Eren, Mehmet; Kutlu, Merih; Yalta, Kenan; Temizhan, Ahmet; Kilicaslan, Baris; Gungor, Hasan; Acikel, Mahmut; Demir, Mesut; Akdemir, Ramazan; Zoghi, Mehdi; Tokgozoglu, Lale
    Objective: Heart failure (HF) is an important health issue of the 21st century and the prevalence in Turkey has been reported as 2.9%. A national profile, frequency data, characteristics of different phenotypes, and risk factors have not yet been well established. The Snapshot Evaluation of Heart Failure Patients in Turkey (SELFIE-TR) was an analysis of a representative sample of HF patients from Turkey. Methods: A total of 23 centers with at least 2 cardiologists from the 12 NUTS-1 regions of Turkey were invited to participate in the research. The contributing centers shared the data of a consecutive enrollment of HF patients, as confirmed by an investigator, on a pre-selected day of each week for the month of October or November of 2015. Results: The mean age of the entire cohort was 63.3 +/- 13.3 years (male/female ratio: 751/303, 71.3%/28.7%). There were 712 acute HF patients and 342 chronic HF patients. The total number of HF patients with reduced ejection fraction (HFrEF), heart failure with mid-range ejection fraction, and heart failure with preserved ejection fraction was 801 (75%), 176 (16.7%), and 77 (7.3%), respectively. The patients with chronic HF were younger than those with acute HF (61.1 +/- 13.3 years vs 67.9 +/- 12.1 years; p<0.001). Among the whole cohort, hypertension was observed in 46%, diabetes mellitus was present in 27.5%, chronic obstructive pulmonary disease was present in 12.8%, and previous myocardial infarction was noted in 45.2%. In patients with HFrEF, the use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, a beta blocker, or a mineralocorticoid receptor antagonist was noted in 74.7%, 89.7%, and 60.9%, respectively. Conclusion: The SELFIE-TR findings provide important insight, since it is the first study to make a snapshot of HF patients in our country. These data may help to create standardized prevention and treatment strategies.
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    What have we learned from Turkish familial hypercholesterolemia registries (A-HIT1 and A-HIT2)?
    (Elsevier Ireland Ltd, 2018) Kayikcioglu, Meral; Tokgozoglu, Lale; Dogan, Volkan; Ceyhan, Ceyhun; Tuncez, Abdullah; Kutlu, Merih; Onrat, Ersel; Alici, Gokhan; Akbulut, Mehmet; Celik, Ahmet; Yesilbursa, Dilek; Sahin, Tayfun; Sonmez, Alper; Ozdogan, Oner; Temizhan, Ahmet; Kilic, Salih; Bayram, Fahri; Sabuncu, Tevfik; Coskun, Fatma Yilmaz; Ildizli, Muge; Durakoglugil, Emre; Kirilmaz, Bahadir; Yilmaz, Mehmet Birhan; Yigit, Zerrin; Yildirim, Aytul Belgi; Gedikli, Omer; Topcu, Selim; Oguz, Aytekin; Demir, Mesut; Yenercag, Mustafa; Yildirir, Aylin; Demircan, Sabri; Yilmaz, Mehmet; Kaynar, Leyla Gul; Aktan, Melih; Durmus, Rana Berru; Gokce, Cumali; Ozcebe, Osman Ilhami; Akyol, Tulay Karaagac; Okutan, Harika; Sag, Saim; Gul, Ozen Oz; Salcioglu, Zafer; Altunkeser, Bulent Behlul; Kuku, Irfan; Yasar, Hurriyet Yilmaz; Kurtoglu, Erdal; Kose, Melis Demir; Demircioglu, Sinan; Pekkolay, Zafer; Ilhan, Osman; Can, Levent H.
    Background and aims: Familial hypercholesterolemia (FH) is a common genetic disease of high-level cholesterol leading to premature atherosclerosis. One of the key aspects to overcome FH burden is the generation of largescale reliable data in terms of registries. This manuscript underlines the important results of nation-wide Turkish FH registries (A-HIT1 and A-HIT2). Methods: A-HIT1 is a survey of homozygous FH patients undergoing low density lipoprotein (LDL) apheresis (LA). A-HIT2 is a registry of adult FH patients (homozygous and heterozygous) admitted to outpatient clinics. Both registries used clinical diagnosis of FH. Results: A-HIT1 evaluated 88 patients (27 +/- 11 years, 41 women) in 19 centers. All patients were receiving regular LA. There was a 7.37 +/- 7.1-year delay between diagnosis and initiation of LA. LDL-cholesterol levels reached the target only in 5 cases. Mean frequency of apheresis sessions was 19 +/- 13 days. None of the centers had a standardized approach for LA. Mean frequency of apheresis sessions was every 19 +/- 13 (7-90) days. Only 2 centers were aware of the target LDL levels. A-HIT2 enrolled 1071 FH patients (53 +/- 8 years, 606 women) from 31 outpatients clinics specialized in cardiology (27), internal medicine (1), and endocrinology (3); 96.4% were heterozygous. 459 patients were on statin treatment. LDL targets were attained in 23 patients (2.1% of the whole population, 5% receiving statin) on treatment. However, 66% of statin-receiving patients were on intense doses of statins. Awareness of FH was 9.5% in the whole patient population. Conclusions: The first nationwide FH registries revealed that FH is still undertreated even in specialized centers in Turkey. Additional effective treatment regiments are urgently needed.