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Turkish Journal of Medical Sciences

Author ORCID Identifier

SANEM NALBANTGİL: 0000-0002-9798-9796

EMRE DEMİR: 0000-0001-7552-8967

AHMET ÇELİK: 0000-0002-9417-7610

İNCİ TUĞÇE ÇÖLLÜOĞLU: 0000-0002-2227-6177

NAİM ATA: 0000-0001-6947-2821

MEHMET YILMAZ: 0000-0002-8169-8628

ANIL ŞAHİN: 0000-0003-3416-5965

DİLEK URAL: 0000-0003-0224-1433

MUSTAFA ÜLGÜ: 0000-0003-0825-1851

EMİNE KANIK: 0000-0002-7068-1599

LALE DİNÇ ASARCIKLI: 0000-0002-7828-9487

YÜKSEL ÇAVUŞOĞLU: 0000-0002-4027-9873

SELDA MURAT: 0000-0002-3935-0222

ŞUAYİP BİRİNCİ: 0000-0001-8104-6198

DOI

10.55730/1300-0144.5933

Abstract

Background/aim: Effective management of heart failure involves evidence-based use of multiple medications and their combinations. Furthermore, dosage escalation of the recommended medications is advised. In cases of advanced heart failure, long-term mechanical assistance devices or heart transplantation surgery may be necessary. The socio-economic situation creates unequal chances for people to access these treatments.The study aimed to analyze and compare medical and advanced heart failure treatments recommended by guidelines across various regions in Türkiye.Materials and methods: About 85 million citizen medical treatment records were utilized between January 1, 2016, and December 31, 2022. Medical and heart replacement treatment opportunities used in heart failure in Türkiye were evaluated in the general population and different geographical regions.Results: According to this study, beta-blockers were the most commonly prescribed medication for heart failure in Türkiye. This was followed by angiotensin-converting enzyme inhibitors (ACEi) at 44% and mineralocorticoid receptor antagonists (MRA) at 38.9%. However, only 0.6% of patients used angiotensin receptor blocker-neprilysin inhibitors (ARNI). Despite the high incidence of diabetes mellitus among heart failure patients, only 11% used sodium-glucose cotransporter two inhibitors (SGLT-2i). The study also found that using an Implantable Cardioverter Defibrillator (ICD) was 0.8%, and Cardiac Resynchronization Therapy (CRT) was 0.3% among all intracardiac device treatments. Heart replacement therapies, cardiac transplantation surgery, and long-term left ventricle-assisted device (LVAD) surgery had very low rates.Conclusion: The use of guideline-directed medical therapy is not optimal in Türkiye. Also, it differs within different geographical regions. It is a fact that heart transplant or LVAD surgery, CRT, and ICD implantation rates in Türkiye are significantly lower than in developed countries, regardless of geographical regions.

Keywords

Device therapy, heart failure, medical therapy, nationwide study

First Page

1470

Last Page

1477

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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