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Öğe Burden of comorbidities in heart failure patients in Türkiye(TUBITAK, 2024-05-07) Çavuşoğlu, Yüksel; Murat, Selda; Şahin, Anıl; Çöllüoğlu, İnci Tuğçe; Ural, Dilek; Yilmaz, Mehmet Birhan; Nalbantgil, Sanem; Nalbantgil, Sanem; Ülgü, Mustafa Mahir; Birinci, Şuayip; Demir, Emre; Kanik, Emine Arzu; Asarcikli, Lale Dinç; Çelik, AhmetBackground/aim: Heart failure (HF) is associated with a wide range of comorbidities that negatively impact clinical outcomes and cause high economic burden. We aimed to evaluate the frequency and burden of comorbidities in HF patients in Türkiye and their relationships with patients’ demographic characteristics. Materials and methods: Based on ICD-10 codes in the national electronic database of the Turkish Ministry of Health covering the entire population of Türkiye (n = 85,279,553) from 1 January 2016 to 31 December 2022, data on the prevalence of comorbidities in HF patients were obtained. The frequency and burden of comorbidities were analyzed separately by age groups, sex, and socioeconomic status (SES). Results: Between 2016 and 2022, there were 2,722,151 patients (51.7% female) of all ages who were diagnosed with HF. In Türkiye, the most common comorbidities of HF patients were hypertension (HT) (97.6%), atherosclerotic cardiovascular disease (ASCVD) (84.9%), dyslipidemia (59.5%), anxiety disorder (48.1%), diabetes mellitus (DM) (45.2%), chronic obstructive pulmonary disease (COPD) (43.6%), anemia (40.6%), and atrial fibrillation (AF) (37.1%). Female patients had higher rates of anemia, DM, HT, and anxiety disorders, while male patients had higher rates of ASCVD, COPD, and dyslipidemia. The most common comorbidity in patients under 20 years of age was congenital heart disease (52.3%). More than 90% of HF patients had ≥2 comorbidities. HF patients with ≥5 comorbidities increased from 18.1% in the group aged 20–49 years to 38.3% in the group aged 50–79 years. Comorbidities were similar across SES groups. Conclusion: The most common comorbidities in cases of HF in Türkiye are HT, ASCVD, dyslipidemia, DM, COPD, anemia, and AF, respectively, and more than 90% of patients have ≥2 comorbidities. While ASCVD and dyslipidemia were more common in male patients, anemia, DM, and anxiety disorders were more common in female patients. The number of comorbid conditions increased with advanced age.Öğe Diagnostic approach to heart failure in Türkiye.(TUBITAK, 2024-05-07) Ural, Dilek; Asarcikli, Lale Dinç; Çöllüoğlu, İnci Tuğçe; Şahin, Anıl; Çavuşoğlu, Yüksel; Yilmaz, Mehmet Birhan; Nalbantgil, Sanem; Ata, Naim; Ülgü, Mustafa Mahir; Birinci, Şuayip; Murat, Selda; Demir, Emre; Kanik, Emine Arzu; Çelik, AhmetBackground/aim: Final diagnosis of heart failure (HF) relies on a combination clinical findings, laboratory and imaging tests. The aim of this study was to review the diagnostic approach to HF in Türkiye. Materials and methods: This study is a subanalysis of the nationwide TRends-HF study, based on anonymized data from National Electronic Database between January 1, 2016, and December 31, 2022. Variables including date of birth, sex, socioeconomic development index, place of initial HF diagnosis, comorbidities, investigations, and diagnostic procedures were reported. Laboratory variables, including complete blood count, natriuretic peptides (NP), estimated glomerular filtration rate, uric acid, electrolytes, albumin, lipid profile, ferritin and hemoglobin A1c levels, and other imaging techniques (coronary angiogram [CAG], transthoracic echocardiography [TTE], chest X-ray [CXR], etc.) during the initial diagnosis and/or follow-up of HF patients, were obtained from the National Electronic Database. The diagnostic test usage rates were analyzed according to years, geographical regions, and socioeconomic regions of Türkiye. Results: The study population consisted of 2,722,151 HF patients (51.7% female, mean age 68.33 ± 14.01 years). All HF patients had at least one electrocardiogram and one TTE examination, and all underwent routine biochemical tests at least once during the follow-up period. CXR utilization rate was 93.7%, while CAG utilization rate was 17.9%. Coronary computed tomographic angiography and cardiac magnetic resonance imaging were performed in only 1.8% and 0.3% of patients, respectively. Among all Turkish HF patients, 16.3% had at least one NP measurement. The highest rate of NP use was observed in the Central Anatolia Region (21.0%), while the lowest rate was in the Aegean Region (11.7%). NP measurement during HF diagnosis revealed a rising trend over time (12.3% in 2016 vs. 26.3% in 2021). Conclusion: The widespread use of TTE at the beginning of the diagnosis and during follow-up is important for providing quality care to HF patients in Türkiye. However, detailed laboratory tests and advanced imaging methods are not utilized sufficiently, which could lead to issues in patient management.Öğe Epidemiology of heart failure in Türkiye(TUBITAK, 2024-12-13) Ata, Naim; Çöllüoğlu, İnci Tuğçe; Şahin, Anıl; Yilmaz, Mehmet Birhan; Nalbantgil, Sanem; Birinci, Şuayip; Ülgü, Mustafa Mahir; Kanik, Emine Arzu; Ural, Dilek; Asarcikli, Lale Dinç; Demir, Emre; Çavuşoğlu, Yüksel; Murat, Selda; Çelik, AhmetBackground/aim: The epidemiological data on heart failure (HF) vary between regions within the same country. We aimed to investigate the epidemiological data on HF in Türkiye across all age groups regarding seven geographical regions. Materials and methods: We included all patients from the Turkish population who received a first diagnosis of HF between January 1, 2016 and December 31, 2022, using ICD-10 codes from the National Electronic Healthcare Database. The data were categorized by seven geographical regions of Türkiye. Results: The median age of index diagnosis of HF was 70 (60–78) years in all age groups and 4 (1–12) years in pediatric population. The prevalence rate of HF was the highest in the Black Sea Region at 3.103%, while the Southeastern Anatolia Region exhibited the lowest at 1.436%. In all age groups, female patients with HF were older and had a higher prevalence rate across all geographical regions than male patients. From 2017 to 2021, incidence rates of HF declined to 3.0 per 1000 person years, with a consistent decrease for each geographical region. The highest incidence rates of HF were seen in the Black Sea Region, while the Southeastern Anatolia Region had the lowest. Evaluating pediatric population with HF, prevalence of HF was 0.81 per 1000 people (female children: 0.77 per 1000 people, male children: 0.84 per 1000 people). Female children with HF demonstrated the highest prevalence in the Central Anatolia Region with a rate of 1.04 per 1000 people, while male pediatric population with HF exhibited the greatest prevalence of HF in the Mediterranean Region, reaching 0.89 per 1000 people. The lowest prevalence of children with HF in both sexes was observed in the Eastern Anatolia Region (female children: 0.62 per 1000 people, male children: 0.48 per 1000 people). Conclusion: Despite regional variations, prevalence of HF in Türkiye’s regions aligns with global trends. Sex-based differences in HF prevalence were evident across all age groups, including pediatric population. Incidence rates of HF in each region exhibited a substantial decline by 2021.
