Medical and advanced heart failure therapies in Türkiye.

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Turkish Journal of Medical Sciences Pub Date : 2024-05-07 eCollection Date: 2024-01-01 DOI:10.55730/1300-0144.5933
Sanem Nalbantgil, Emre Demir, Ahmet Çelik, İnci Tuğçe Çöllüoğlu, Naim Ata, Mehmet Birhan Yilmaz, Anıl Şahin, Dilek Ural, Mustafa Mahir Ülgü, Emine Arzu Kanik, Lale Dinç Asarcikli, Yüksel Çavuşoğlu, Selda Murat, Şuayip Birinci
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引用次数: 0

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. Socio-economic disparities create unequal opportunities 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 citizens medical treatment records were utilized between January 1, 2016, and December 31, 2022. Medical and heart replacement treatment opportunities for heart failure in Türkiye were evaluated in the general population and across 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 at 44% and mineralocorticoid receptor antagonists at 38.9%. However, only 0.6% of patients used angiotensin receptor blocker-neprilysin inhibitors. Despite the high incidence of diabetes mellitus among heart failure patients, only 11% used sodium-glucose cotransporter two inhibitors. 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 and varies across different geographical regions. It is a fact that heart transplant or LVAD surgery, CRT, and ICD implantation rates in Türkiye are significantly lower than those in developed countries, regardless of geographical region.

医疗和先进的心脏衰竭治疗在 rkiye。
背景/目的:心衰的有效管理包括循证使用多种药物及其联合用药。此外,建议增加推荐药物的剂量。在晚期心力衰竭的情况下,可能需要长期的机械辅助装置或心脏移植手术。社会经济差异造成人们获得这些治疗的机会不平等。该研究旨在分析和比较 kiye不同地区指南推荐的内科和高级心力衰竭治疗方法。材料和方法:2016年1月1日至2022年12月31日期间,利用约8500万份公民医疗记录。对约旦共和国心力衰竭的医疗和心脏替代治疗机会在一般人群和不同地理区域进行了评估。结果:根据这项研究,β受体阻滞剂是最常用的处方药物在 kiye心脏衰竭。其次是血管紧张素转换酶抑制剂(44%)和矿皮质激素受体拮抗剂(38.9%)。然而,只有0.6%的患者使用血管紧张素受体阻滞剂-neprilysin抑制剂。尽管心力衰竭患者中糖尿病的发病率很高,但只有11%的患者使用钠-葡萄糖共转运蛋白2抑制剂。研究还发现,在所有心脏内装置治疗中,使用植入式心律转复除颤器(ICD)的比例为0.8%,心脏再同步化治疗(CRT)的比例为0.3%。心脏替代疗法、心脏移植手术和长期左心室辅助装置(LVAD)手术的发生率非常低。结论:指南性药物治疗在基耶病中应用并不理想,且在不同地理区域存在差异。事实上,无论地理区域如何,日本的心脏移植或LVAD手术、CRT和ICD植入率都明显低于发达国家。
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来源期刊
Turkish Journal of Medical Sciences
Turkish Journal of Medical Sciences 医学-医学:内科
CiteScore
4.60
自引率
4.30%
发文量
143
审稿时长
3-8 weeks
期刊介绍: Turkish Journal of Medical sciences is a peer-reviewed comprehensive resource that provides critical up-to-date information on the broad spectrum of general medical sciences. The Journal intended to publish original medical scientific papers regarding the priority based on the prominence, significance, and timeliness of the findings. However since the audience of the Journal is not limited to any subspeciality in a wide variety of medical disciplines, the papers focusing on the technical  details of a given medical  subspeciality may not be evaluated for publication.
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