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Öğe Marital status and outcomes in chronic heart failure: Does it make a difference of being married, widow or widower?(Istanbul Provincial Directorate of Health, 2021) Şentürk, Bihter; Kaya, Hakkı; Çelik, Ahmet; Bekar, Lütfü; Güngör, Hasan; Zoghi, Mehdi; Ural, Dilek; Çavuşoğlu, Yüksel; Temizhan, Ahmet; Yılmaz, Mehmet BirhanOBJECTIVE: We aimed to compare the outcomes of chronic heart failure (HF) patients with reduced ejection fraction (CHFrEF) in the Turkish Research Team in HF (TREAT-HF) registry according to marital status with a specific focus on being the widowed (widow/widower) versus the married. METHODS: TREAT-HF is a network, enrolling CHFrEF with a follow up for HF-related hospitalization (HFrH) and all-cause mortality (ACM). In this cohort, the widowed patients were compared with patients who were married before and after propensity score (PS) matching analysis. RESULTS: There were 723 cHFrEF patients with a complete dataset, including reported marital status at baseline for this analysis. Out of 723 patients with HF, 37 “never-married” and “divorced” patients were excluded from the analysis. Then, out of 686 remaining patients with HF, who had at least one reported marriage in the database, widowed patients with HF (n=124) were compared with married patients (n=562). The mean follow up period was 21±12 months up to 48 months. The widowed patients had a higher risk of HFrH (p=0.047), although ACM remained similar compared to married patients (p=0.054). After PS matching, HFrH remained more frequent among the widowed compared with the married (p=0.039) although ACM yielded similar rates. Of note, it was shown that being a widower (p=0.419) was not linked to increased risk of HFrH during follow up contrary to being a widow (p=0.037) despite similar age, ejection fraction, creatinine, NYHA functional class distribution and a similar rate of life-saving medications. CONCLUSION: PS matching analysis yielded that the widowed had increased the risk for HFrH. Of note, widowers did not seem to have an increased risk for HFrH, contrary to widows.Öğe Noncompliance with Dietary Salt Restriction and Outcomes in Chronic Heart Failure: A Propensity Score Matching Analysis from TREAT-HF Registry(University of Health Sciences Turkey, Istanbul Haseki Training and Research Hospital, 2021) Şentürk, Bihter; Kaya, Hakkı; Çelik, Ahmet; Bekar, Lütfü; Güngör, Hasan; Zoghi, Mehdi; Ural, Dilek; Çavusoglu, Yüksel; Temizhan, Ahmet; Yılmaz, Mehmet BirhanAim: To compare chronic heart failure patients with reduced ejection fraction (cHFrEF) who stated to comply with salt restriction in their diets versus those who did not. Methods: Patients without salt restriction were compared to those with salt restriction regarding HF-related hospitalization (HFrH) and all-cause mortality (ACM) before and after propensity score (PS) matching analysis. Results: The study included a total of 723 patients. 136 of them stated not to comply with salt restriction, 587 of them stated to comply with salt restriction. More frequent HFrH were observed in patients without salt restriction compared to those with salt restriction (75% vs. 62.9%, p=0.007), though, ACM was similar in both groups (29.4% vs 27.6%, p=0.672). After PS matching, HFrH during follow-up remained more frequent in those without salt restriction compared to those with salt restriction (73.7% vs 59.3%, p=0.019) but ACM was not different in both groups (30.5% vs 29.7%, p=0.887). Noncompliance to dietary salt restriction was found as one of the independent predictors of HFrH. Conclusion: In cHFrEF outpatients, noncompliance to dietary salt restriction does not seem to increase the risk for ACM but it poses an increased risk for HFrH.Öğe SURF (SUrvey of Risk Factor Management) çalışması Türkiye değerlendirmesi: Farklı basamaklardan 15 sağlık merkezinin verilerinde kardiyovasküler risk faktörleri kontrol oranları(2017) Tokgözoğlu, Sadberk Lale; Oğuz, Aytekin; Balcı, Mustafa Kemal; Temizhan, Ahmet; Altunoğlu, Esma Güldal; Bektaş, Osman; Aslan, GülerAmaç: Bu çalışmanın amacı, ülkemizdeki değişik basamaklardaki sağlık merkezlerinde izlenmekte olan koroner kalp hastalığı (KKH) olan hastalarda sekonder koruma önerilerine uyum ve risk faktörleri kontrolü için önerilen hedef değerlere ulaşım oranlarının değerlendirilmesi.Yöntemler: Birinci, ikinci ve üçüncü basamaklardan seçilmiş toplam 15 merkezde izlenmekte olan KKH'li hastaların uluslararası SURF (Survey of Risk Factor management) protokolüne uygun olarak anket formları doldurularak, demografik, antropometrik ve laboratuvar verileri kaydedildi.Bulgular: Çalışmaya alınan toplam 724 KKH'li hastanın (%69.8 erkek, ortalama yaş: 63.3±10.7) %18.4'ü halen sigara kullanmakta, sadece %19.1'inin beden kütle indeksi normal sınırlarda ve %22.1'inin bel çevresi abdominal obezite sınırının altında idi. Hastaların %53'ünün fiziksel aktivite düzeyleri yetersiz, %47.3'ünün yüksek yoğunluklu lipoprotein kolestrol düzeyi düşük, %46'sının trigliserit düzeyi 150 mg/dL'nin üstünde, %67'sinin HbA1c düzeyi %6.5 ve üzerindeydi. Hastaların %88.1'i antiagregan, %71.4'ü beta bloker, %55.7'si statin ve %41.9'u anjiyotensin dönüştürücü enzim inhibitörü/anjiyotensin reseptör blokeri kullanmaktaydı. Hipertansiyonu olan ve antihipertansif ilaç kullanan hasta grubunun %56.7'sinde kan basıncı kontrol altında, diyabet tanısı olan ve antidiyabetik ilaç kullanan hasta grubunda glisemik kontrol hedeflerine ulaşma oranı %35.9 idi. Statin kullanan hasta grubunun %12.2'sinde düşük yoğunluklu lipoprotein kolestrol 70 mg/dL'nin altındaydı.Sonuç: Ülkemizdeki çeşitli basamaklardaki sağlık merkezlerinden elde edilen verilere göre, KKH'li hastalarda kardiyovasküler risk faktörleri kontrol oranı düşük, güncel kılavuzların önerdiği yaşam tarzı değişiklikleri ve ilaç kullanımı yetersizdir.Öğe Turkish assessment of SURF (SUrvey of Risk Factor Management) study: Control rates of cardiovascular risk factors derived from databases of 15 different levels of health centers in Turkey(Kare Publ, 2017) Tokgozoglu, Lale; Oguz, Aytekin; Balci, Mustafa Kemal; Temizhan, Ahmet; Altunoglu, Esma Guldal; Bektas, Osman; Aslan, GulerObjective: The aim of this study was to evaluate the adherence to recommendations for secondary prevention and the achievement of treatment targets for the control of risk factors in patients with established coronary heart disease (CHD) who were followed-up at various healthcare facilities in Turkey. Methods: According to the protocol of the international Survey of Risk Factor Management study, questionnaire forms were completed and demographic, anthropometric, and laboratory data of CHD patients who were followed-up at a total of 15 selected primary, secondary, and tertiary healthcare centers were recorded. Results: Among a total of 724 CHD patients (69.8% male; mean age: 63.3 +/- 10.7 years) included in the study, 18.4% were current smokers, only 19.1% had normal body mass index, and 22.1% had waist circumference below the limit of abdominal obesity. Physical activity was insufficient in 53% of the patients, 47.3% had low high-density lipoprotein cholesterol value, 46% had triglyceride level above 150 mg/dL, and 67% had glycated hemoglobin value of 6.5% or above. Of all the patients, 88.1% were using antiplatelet drugs, 71.4% were using beta-blockers, 55.7% were using statins, and 41.9% were using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Blood pressure was under control in 56.7% of the hypertensive patients using antihypertensive drugs, and the proportion of diabetic patients who reached glycemic control targets using antidiabetic drugs was 35.9%. Low-density lipoprotein cholesterol was below 70 mg/dL in 12.2% of the patients using statins. Conclusion: According to the data obtained, among Turkish CHD patients, the control rate of cardiovascular risk factors is low, and implementation of the recommendations regarding lifestyle modification and medication use for secondary prevention in the current guidelines are insufficient.
