Browsing by Author "Aras, Dursun"

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Antithrombotic treatment patterns and stroke prevention in patients with atrial fibrillation in Turkey: Inferences from GARFIELD-AF registry
(2019) Sayin, Begum Yetis; Okutucu, Sercan; Yilmaz, Mehmet Bircan; Ozdemir, Kurtulus; Aydinlar, Ali; Sahin, Durmus Yildiray; Altun, Armagan; Acikel, Sadik; Okuyan, Ertugrul; Sucu, Murat; Ongen, Zeki; Ersanli, Murat Kazim; Yilmaz, Ozcan; Demir, Mesta; Pekdemir, Hasan; Topsakal, Ramazan; Sahiner, Mehmet Levent; Aras, Dursun; Oto, Ali; 31062761; ABB-5844-2020
Objective: The corner stone of atrial fibrillation therapy includes the prevention of stroke with less adverse effects. The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) study provided data to compare treatment strategies in Turkey with other populations and every-day practice of stroke prevention management with complications. Methods: GARFIELD-AF is a large-scale registry that enrolled 52,014 patients in five sequential cohorts at > 1.000 centers in 35 countries. This study was initiated to track the evolution of global anticoagulation practice, and to study the impact of NOAC therapy in AF. A total of 756 patients from 17 enrolling sites in Turkey were in cohort 4 and 5. Treatment strategies at diagnosis initiated by CHA(2)DS(2)-VASc score, baseline characteristics of patients, treatment according to stroke and bleeding risk profiles, and INR values were analyzed in cohorts. Additionally, event rates during the first year follow up were evaluated. Results: AF patients in Turkey were mostly seen in young women. Stroke risk according to the CHADS(2) score and CHA(2)DS(2)-VASc score compared with world data. The mean of risk score values, including HAS-BLED score were lower in Turkey than in the world data. The percentage of patients receiving FXa inhibitor with or without an antiplatelet usage was more than the other drug groups. All-cause mortality was higher in Turkey. Different form world data when HAS-BLED score was above 3, the therapy was mostly changed to antiplatelet drugs in Turkey. Conclusion: In addition to deficiencies in available treatment options, patient care and clinical outcomes of patients with AF, the data of GARFIELD-AF provide data from Turkey about therapeutic strategies and best practices.
Association of prediabetes with diffuse coronary narrowing and small-vessel disease
(2014) Ertan, Cagatay; Ozeke, Ozcan; Gul, Murat; Aras, Dursun; Topaloglu, Serkan; Kisacik, Halil Lutfi; Demir, Ahmet Duran; Aydogdu, Sinan; Ozin, Bulent
Background: A significant number of patients may not benefit from conventional techniques of myocardial revascularization due to diffuse coronary artery disease (CAD) or small coronary arterial sizes because of smaller arteries causing anastomotic technical difficulties and poor run-off. Diabetic patients have a more severe and diffuse coronary atherosclerosis with smaller coronary arteries limiting the possibility to perform a successful and complete revascularization, but this has not been examined in prediabetics. Objective: To evaluate whether there is an association between prediabetes and the coronary arterial size. Methods: We prospectively studied 168 consecutive patients with CAD and 172 patients with normal coronary artery anatomy (NCA). Patients were divided into three groups according to hemoglobin (Hb) A1c levels as "normal," "prediabetic," and "diabetic" groups, and the coronary artery sizes and Gensini scores were analyzed. Results: There were 78 female patients and 90 male patients in the CAD group, and 87 female patients and 85 male patients in the NCA group. There was a statistically significant difference in distal and proximal total coronary arterial size among the CAD and NCA groups for both genders. There was a positive correlation between the HbA1c subgroups and Gensini score (Spearman's rho: 0.489, p < 0.001 in female group; Spearman's rho: 0.252 p = 0.016 in male group). Conclusion: We found that prediabetic patients have a smaller coronary size and diffuse coronary narrowing for both genders, particularly in distal coronary arterial tree of left anterior descending coronary artery. The early detection of prediabetes in daily cardiology practice may provide more appropriate coronary lesion for percutaneous or surgical revascularization. (C) 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Cost-of-disease of Heart Failure in Turkey: A Delphi Panel-based Analysis of Direct and Indirect Costs
(2022) Cavusoglu, Yuksel; Altay, Hakan; Aras, Dursun; Celik, Ahmet; Ertas, Fatih Sinan; Kilicaslan, Baris; Nalbantgil, Sanem; Temizhan, Ahmet; Ural, Dilek; Yildirimturk, Ozlem; Yilmaz, Mehmet Birhan; 35872647
Background: Heart failure (HF) is considered a significant public health issue with a substantial and growing epidemiologic and economic burden in relation to longer life expectancy and aging global population Aims: To determine cost-of-disease of heart failure (HF) in Turkey from the payer perspective. Study Design: Cross-sectional cost of disease study. Methods: In this cost-of-disease study, annual direct and indirect costs of management of HF were determined based on epidemiological, clinical and lost productivity inputs provided by a Delphi panel consisted of 11 experts in HF with respect to ejection fraction (EF) status (HF patients with reduced EF (HFrEF), mid-range EF (HFmrEF) and preserved EF (HFpEF)) and New York Heart Association (NYHA) classification. Direct medical costs included cost items on outpatient management, inpatient management, medications, and non -pharmaceutical treatments. Indirect cost was calculated based on the lost productivity due to absenteeism and presenteeism. Results: 51.4%, 19.5%, and 29.1% of the patients were estimated to be HFrEF, HFmrEF, and HFpEF patients, respectively. The total annual direct medical cost per patient was $887 and non-pharmaceutical treatments ($373, 42.1%) were the major direct cost driver. Since an estimated nationwide number of HF patients is 1,128,000 in 2021, the total annual national economic burden of HF is estimated to be $1 billion in 2021. The direct medical cost was higher in patients with HFrEF than in those with HFmrEF or HFpEF ($1,147 vs. $555 and $649, respectively). Average indirect cost per patient was calculated to be $3,386 and was similar across HFrEF, HFmrEF and HFpEF groups, but increased with advanced NYHA stage. Conclusion: Our findings confirm the substantial economic burden of HF in terms of both direct and indirect costs and indicate that the non-pharmaceutical cost is the major direct medical cost driver in HF management, regardless of the EF status of HF patients.