Publications by authors named "Yilmaz Mehmet Birhan"

Objective: Limited information is available regarding the associations between upper extremity function, activities of daily living (ADLs), and functional capacity in patients with heart failure with reduced ejection fraction (HFrEF). This study aimed to investigate the associations between upper extremity function, ADLs, and functional capacity in patients with HFrEF.

Methods: This cross-sectional study included 31 patients with HFrEF.

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Background/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.

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Background/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.

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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.

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Background/aim: Despite Türkiye's relatively young population, there is an emerging trend of earlier diagnoses of chronic diseases, including heart failure (HF). This study aims to shed light on survival rates, potential influences of guideline-directed therapies, and sex-based differences necessitating personalized management in HF.

Materials And Methods: We conducted a nationwide retrospective cohort analysis of 2,722,151 patients with HF using deidentified data from the Turkish Ministry of Health's national electronic database.

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Background/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.

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This study evaluated the management of dyslipidemia in Turkey with the goal of understanding current diagnosis and treatment patterns, as well as identifying unmet needs in achieving effective low-density lipoprotein cholesterol (LDL-C) targets. Using a Delphi panel consisting of nine expert cardiologists, the study reveals key gaps in dyslipidemia management, particularly in the underutilization of combination therapies, such as statins and PCSK9 inhibitors, which are crucial for achieving LDL-C targets in high-risk patients. The findings indicate that while many patients with very high cardiovascular risk are diagnosed, a significant proportion do not receive optimal treatment to reach LDL-C levels recommended by European guidelines.

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Purpose: The management of heart failure (HF) frequently includes gastroprotection via proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs). This systematic review evaluates their impact on HF outcomes, including exacerbation, hospitalization, mortality, and major adverse cardiac events (MACE).

Methods: In accordance with PRISMA guidelines, a complete search across databases such as PubMed/Medline, Scopus, and Web of Science was conducted until December 10, 2023.

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Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are breakthrough agents for the treatment of type 2 diabetes mellitus (T2DM) and heart failure (HF). However, among patients with HF and T2DM, some uncertainty remains about individual comparisons, including dosing.

Objectives: We aimed to make a real-life individual comparison of SGLT2is among patients with HF and T2DM.

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Background: In the contemporary management of heart failure with reduced ejection fraction (HFrEF), the recommended quadruple guideline-directed medical therapy (GDMT) consists of angiotensin receptor-neprilysin inhibitor (ARNI), evidence-based beta-blockers (BB), mineralocorticoid receptor antagonists (MRA), and sodium-glucose cotransporter-2 inhibitors (SGLT-2i). This study explored the impact of adding implantable cardioverter-defibrillator (ICD) therapy to this comprehensive regimen in HFrEF patients.

Methods: Utilizing deidentified data from the National Electronic Database of the Turkish Ministry of Health, we conducted a nationwide retrospective cohort study on 5450 HFrEF patients receiving quadruple GDMT, including ARNI.

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Article Synopsis
  • Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, improved outcomes for heart failure patients in the FINEARTS-HF trial but led to elevated serum potassium levels.
  • The study aimed to analyze the frequency of abnormal serum potassium levels (<3.5 mmol/L and >5.5 mmol/L) and the impact of finerenone treatment compared to placebo on patient outcomes.
  • Results showed that participants taking finerenone experienced significantly higher potassium levels over time, with increased risk of levels >5.5 mmol/L and reduced risk of levels <3.5 mmol/L, indicating a notable effect of the drug on potassium regulation.
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Takotsubo syndrome (TTS) still remains as an enigmatic phenomenon. In particular, long-term challenges (including clinical recurrence and persistent symptoms) and specific entities in the setting of TTS have been the evolving areas of interest. On the other hand, a significant gap still exists regarding the proper risk-stratification of this phenomenon in the short and long terms.

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In the recent years, there has been a burgeoning interest in Takotsubo syndrome (TTS), which is renowned as a specific form of reversible myocardial dysfunction. Despite the extensive literature available on TTS, clinicians still face several practical challenges associated with the diagnosis and management of this phenomenon. This potentially results in the underdiagnosis and improper management of TTS in clinical practice.

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Purpose: The relationship between heart failure (HF) and hormone replacement therapy (HRT) in postmenopausal women remains unclear. This paper aimed to elucidate the association between HRT and HF outcomes in postmenopausal women by scrutinizing evidence from clinical trials and observational studies.

Methods: The meta-analysis was systematically executed following the PRISMA guidelines to include studies identified from the electronic databases, including PubMed, EMBASE, EBSCO, ICTRP, and NIH clinical trials.

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Article Synopsis
  • Sodium-glucose cotransporter-2 inhibitors (SGLT2i) help lower blood glucose and sodium levels by promoting their excretion in urine, leading to benefits like reduced heart failure (HF) hospitalizations in patients with type 2 diabetes (T2DM) and cardiovascular (CV) risks.
  • Clinical trials like DAPA-HF and EMPEROR-Reduced demonstrate that SGLT2i medications (dapagliflozin and empagliflozin) significantly reduce CV mortality and HF hospitalizations in heart failure patients, whether they have T2DM or not.
  • Recent studies, including EMPEROR-Preserved and DELIVER, also support the effectiveness of SGLT2is in treating heart
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Article Synopsis
  • Steroidal mineralocorticoid receptor antagonists help patients with heart failure and reduced ejection fraction, but their effectiveness in those with mildly reduced or preserved ejection fraction is unclear, indicating a need for further research on finerenone.
  • In a double-blind study, patients with heart failure (ejection fraction 40% or greater) were assigned to receive either finerenone or a placebo to assess its impact on heart failure events and cardiovascular death.
  • Results showed that finerenone led to fewer worsening heart failure events and a lower overall rate of primary outcome events compared to placebo, although it also carried a higher risk of hyperkalemia.
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(1) Background: Dyslipidaemia and insulin resistance are major risk factors for coronary artery disease (CAD). This study investigated the relationship between plasma atherogenic index (PA-I), triglyceride-glucose index (TGI) and other lipid ratios with the presence and prediction of CAD among different age categories. (2) Methods: The study included 223 participants diagnosed with CAD and those with normal coronary arteries (normal group) by coronary computed tomography angiography (CCTA).

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Aims: To describe the baseline characteristics of participants in the FINEARTS-HF trial, contextualized with prior trials including patients with heart failure (HF) with mildly reduced and preserved ejection fraction (HFmrEF/HFpEF). The FINEARTS-HF trial is comparing the effects of the non-steroidal mineralocorticoid receptor antagonist finerenone with placebo in reducing cardiovascular death and total worsening HF events in patients with HFmrEF/HFpEF.

Methods And Results: Patients with symptomatic HF, left ventricular ejection fraction (LVEF) ≥40%, estimated glomerular filtration rate ≥ 25 ml/min/1.

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Background: Scientific evidence regarding the impact of different combinations of diabetes medications in heart failure patients with diabetes mellitus (HFwDM) remains limited.

Aim: We aimed to investigate the effect of monotherapy and combination therapy for DM on all-cause mortality in HFwDM under triple guideline-directed medical therapy (GDMT).

Method: This nationwide retrospective cohort study included adult HFwDM under triple GDMT between January 1, 2016 and December 31, 2022.

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Aims: Digoxin has been used in the treatment for heart failure for centuries, but the role of this drug in the modern era is controversial. A particular concern is the recent observational findings suggesting an increase in all-cause mortality with digoxin, although such observations suffer from biased results since these studies usually do not provide adequate compensation for the severity of disease. Using a nationwide registry database, we aimed to investigate whether digoxin is associated with 1-year all-cause mortality in patients with heart failure irrespective of phenotype.

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Soluble guanylate cyclase (sGC) modulation has been scrutinized in several disease states including heart failure (HF). Recently, it was shown that an sGC modulator improved HF-related hospitalization significantly, though, there was no benefit related to mortality. Herein, a comprehensive meta-analysis of randomized controlled trials (RCTs) for sGC modulation in HF patients was provided in agreement with the PRISMA statement.

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Background: The association of soluble suppression of tumorigenesis-2 (sST2) levels with prognosis in pulmonary embolism (PE) is unknown.

Objective: This study aimed to investigate the relationship between sST2 levels in patients with acute PE and 6-month mortality and recurrent hospitalizations.

Methods: This prospective study included 100 patients with acute PE.

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Article Synopsis
  • Implantable devices help patients with heart failure by working alongside medicines to treat the condition and improve their health.
  • While some devices are supported by strong evidence and show positive effects, others need more research before they can be widely used.
  • The Heart Failure Association and European Heart Rhythm Association suggest a better way to use these devices in care programs to help patients more effectively.
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Major heart failure (HF) trials remain insufficient in terms of assessing the differences in clinical characteristics, biomarkers, treatment efficacy, and safety because of the under-representation of women. The study aimed to present sex-related disparities in HF management, including differences in demographics, co-morbidities, cardiac biomarkers, prescribed medications, and treatment outcomes. The study utilized anonymized data from the Turkish Ministry of Health's National Electronic Database between January 1, 2016, and December 31, 2022.

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Background: Central Illustration: Usefulness of Age, Creatinine and Ejection Fraction - Modification of Diet in Renal Disease Score for Predicting Survival in Patients with Heart Failure Summary of the study design and key findings. ACEF: Age, creatinine and ejection fraction, MDRD: Modified Diet in Renal Disease. While many risk models have been developed to predict prognosis in heart failure (HF), these models are rarely useful for the clinical practitioner as they include multiple variables that might be time-consuming to obtain, they are usually difficult to calculate, and they may suffer from statistical overfitting.

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