PubMed Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10763
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Item Practical approaches for the treatment of chronic heart failure: Frequently asked questions, overlooked points and controversial issues in current clinical practice(2015) Cavusoglu, Yuksel; Altay, Hakan; Ekmekci, Ahmet; Eren, Mehmet; Kucukoglu, Mehmet Serdar; Nalbantgil, Sanem; San, Ibrahim; Selcuk, Timur; Temizhan, Ahmet; Ural, Dilek; 26574641Heart failure (HF) is a progressive disorder associated with impaired quality of life, high morbidity, mortality and frequent hospitalization and affects millions of people from all around the world. Despite further improvements in HF therapy, mortality and morbidity remains to be very high. The life-long treatment, frequent hospitalization, and sophisticated and very expensive device therapies for HF also leads a substantial economic burden on the health care system. Therefore, implementation of evidence-based guideline-recommended therapy is very important to overcome its worse clinical outcomes. However, HF therapy is a long process that has many drawbacks and sometimes HF guidelines cannot answers to every question which rises in everyday clinical practice. In this paper, commonly encountered questions, overlooked points, controversial issues, management strategies in grey zone and problems arising during follow up of a HF patient in real life clinical practice have been addressed in the form of expert opinions based on the available data in the literature.Item Relation between serum sodium levels and clinical outcomes in Turkish patients hospitalized for heart failure: a multi-center retrospective observational study(2017) Muderrisoglu, Haldun; Avci, Burcak Kilickiran; Kucuk, Murathan; Eren, Mehmet; Kutlu, Merih; Yilmaz, Mehmet Birhan; Cavusoglu, Yuksel; Ongen, Zeki; 0000-0002-9635-6313; 27488755; AAG-8233-2020Objective: The purpose of the study was to analyze the prevalence of hyponatremia and related 1-year outcomes of patients hospitalized for decompensated heart failure with reduced ejection fraction (HFrEF) in Turkish patients. Methods: A total of 500 hospitalized patients with HFrEF were consecutively included in a retrospective study at 19 participating hospitals. Patients were categorized according to their serum sodium levels (sNa) on admission day as normonatremic (135-145 mEq/L) and hyponatremic (< 135 mEq/L). One-year all-cause mortality, re-hospitalization rates, and the impact of the changes in sNa at the time of discharge to clinical outcomes were examined. Results: Hyponatremia was observed in 29% of patients. Patients with hyponatremia had lower blood pressures, creatinine clearance, and left ventricular ejection fraction and higher serum creatinine and BUN levels on admission compared with those with normonatremia. Hyponatremia was associated with higher 1-year all-cause mortality (14% vs. 2.6%, p< 0.001) and re-hospitalization rates (46.9% vs. 33.7%, p=0.005). After adjustment for covariates, hyponatremia was independently associated with 1-year all-cause mortality (adjusted HR, 4.762; 95% CI, 1.941-11.764; p= 0.001). At discharge, only 50.8% of hyponatremic patients were corrected to normonatremia (>= 135 mEq/L). Those with persistent hyponatremia had the highest all-cause mortality (p< 0.001). Conclusion: In this study, it is demonstrated that hyponatremia is relatively common and is associated with increased 1-year all-cause mortality and re-hospitalization rates among Turkish patients hospitalized with HFrEF. Approximately 50% of the patients with initial low sNa had persistent hyponatremia at discharge, and these patients had the worst clinical outcomes.