Browsing by Author "Ozdemir, Ibrahim"

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ADHERENCE TO GUIDELINE-DIRECTED MEDICAL AND DEVICE THERAPY IN HEART FAILURE WITH REDUCED EJECTION FRACTION
(2020) Kocabas, Umut; Kivrak, Tarik; Oztekin, Gulsum Meral Yilmaz; Tanik, Veysel Ozan; Ozdemir, Ibrahim; Kaya, Ersin; Yuce, Elif Ilkay; Demir, Fulya Avci; Dogdus, Mustafa; Pehlivanoglu, Seckin; ABA-3670-2020
Gender-related clinical and management differences in patients with chronic heart failure with reduced ejection fraction
(2020) Kocabas, Umut; Kivrak, Tarik; Yilmaz Oztekin, Gulsum Meral; Tanik, Veysel O.; Ozdemir, Ibrahim; Kaya, Ersin; Yuce, Elif Ilkay; Avci Demir, Fulya; Dogdus, Mustafa; Altinsoy, Meltem; Ustundag, Songul; Ozyurtlu, Ferhat; Karagoz, Ugur; Karakus, Alper; Urgun, Orsan Deniz; Sinan, Umit Yasar; Mutlu, Inan; Sen, Taner; Astarcioglu, Mehmet Ali; Kinik, Mustafa; Ozden Tok, Ozge; Uygur, Begum; Yeni, Mehtap; Alan, Bahadir; Dalgic, Onur; Altay, Hakan; Pehlivanoglu, Seckin; 33063424; AAE-1392-2021
Aim Gender-related differences have been described in the clinical characteristics and management of patients with chronic heart failure with reduced ejection fraction (HFrEF). However, published data are conflictive in this regard. Methods We investigated differences in clinical and management variables between male and female patients from the ATA study, a prospective, multicentre, observational study that included 1462 outpatients with chronic HFrEF between January and June 2019. Results Study population was predominantly male (70.1%). In comparison to men, women with chronic HFrEF were older (66 +/- 11 years vs 69 +/- 12 years, P < .001), suffered more hospitalisations and presented more frequently with NYHA class III or IV symptoms. Ischaemic heart disease was more frequent in men, whereas anaemia, thyroid disease and depression were more frequent in women. No difference was seen between genders in the use rate of renin-angiotensin system inhibitors, beta-blockers, mineralocorticoid receptor antagonists, or ivabradine, or in the proportion of patients achieving target doses of these drugs. Regarding device therapies, men were more often treated with an implantable cardioverter-defibrillator (ICD) and women received more cardiac resynchronisation therapy. Conclusion In summary, although management seemed to be equivalent between genders, women tended to present with more symptoms, require hospitalisation more frequently and have different comorbidities than men. These results highlight the importance of gender-related differences in HFrEF and call for further research to clarify the causes of these disparities. Gender-specific recommendations should be included in future guidelines in HFrEF.
Prognostic Significance of Medical Therapy in Patients with Heart Failure with Reduced Ejection Fraction
(2023) Kocabas, Umut; Ergin, Isil; Kivrak, Tarik; Oztekin, Gulsum Meral Yilmaz; Tanik, Veysel Ozan; Ozdemir, Ibrahim; Demir, Fulya Avci; Dogdus, Mustafa; Sen, Taner; Altinsoy, Meltem; Ustundag, Songul; Urgun, Orsan Deniz; Sinan, Umit Yasar; Uygur, Begum; Yeni, Mehtap; Ozcalik, Emre; 0000-0001-6424-9399; 37804042; GXG-7709-2022
Aims The use of guideline-directed medical therapy (GDMT) among patients with heart failure (HF) with reduced ejection fraction (HFrEF) remains suboptimal. The SMYRNA study aims to identify the clinical factors for the non-use of GDMT and to determine the prognostic significance of GDMT in patients with HFrEF in a real-life setting.Methods and results The SMYRNA study is a prospective, multicentre, and observational study that included outpatients with HFrEF. Patients were divided into three groups according to the status of GDMT at the time of enrolment: (i) patients receiving all classes of HF medications including renin-angiotensin system (RAS) inhibitors, beta-blockers, and mineralocorticoid receptor antagonists (MRAs); (ii) patients receiving any two classes of HF medications (RAS inhibitors and beta-blockers, or RAS inhibitors and MRAs, or beta-blockers and MRAs); and (iii) either patients receiving class of HF medications (only one therapy) or patients not receiving any class of HF medications. The primary outcome was a composite of hospitalization for HF or cardiovascular death. The study population consisted of 1062 patients with HFrEF, predominantly men (69.1%), with a median age of 68 (range: 20-96) years. RAS inhibitors, beta-blockers, and MRAs were prescribed in 76.0%, 89.4%, and 55.1% of the patients, respectively. The proportions of patients receiving target doses of guideline-directed medications were 24.4% for RAS inhibitors, 11.0% for beta-blockers, and 11.1% for MRAs. Overall, 491 patients (46.2%) were treated with triple therapy, 353 patients (33.2%) were treated with any two classes of HF medications, and 218 patients (20.6%) were receiving only one class of HF medication or not receiving any HF medication. Patient-related factors comprising older age, New York Heart Association functional class, rural living, presence of hypertension, and history of myocardial infarction were independently associated with the use or non-use of GDMT. During the median 24-month period, the primary composite endpoint occurred in 362 patients (34.1%), and 177 of 1062 (16.7%) patients died. Patients treated with two or three classes of HF medications had a decreased risk of hospitalization for HF or cardiovascular death compared with those patients receiving <= 1 class of HF medication [hazard ratio (HR): 0.65; 95% confidence interval (CI): 0.49-0.85; P = 0.002, and HR: 0.61; 95% CI: 0.47-0.79; P < 0.001, respectively].Conclusions The real-life SMYRNA study provided comprehensive data about the clinical factors associated with the non-use of GDMT and showed that suboptimal GDMT is associated with an increased risk of hospitalization for HF or cardiovascular death in patients with HFrEF.