ISSN 1016-5169 | E-ISSN 1308-4488
Clinical Management Strategies of Cardiologists in Heart Failure with Reduced Ejection Fraction in Türkiye [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2024; 52(8): 581-589 | DOI: 10.5543/tkda.2024.32050

Clinical Management Strategies of Cardiologists in Heart Failure with Reduced Ejection Fraction in Türkiye

Umut Kocabaş1, Emre Özçalık1, Tarık Kıvrak2, Cihan Altın3, Uğur Önsel Türk3
1Department of Cardiology, Başkent University Izmir Hospital, Izmir, Türkiye
2Department of Cardiology, Fırat University, Faculty of Medicine, Elazığ, Türkiye
3Department of Cardiology, Izmir University of Economics, Faculty of Medicine, Medical Point Hospital, Izmir, Türkiye


OBJECTIVE
Integrating heart failure (HF) guideline recommendations into clinical practice takes time and is often suboptimal in real-life settings. Physician-related factors may be significant barriers to the adoption of these guidelines. This survey aims to assess the current opinions of cardiologists practicing in Türkiye regarding the management of heart failure with reduced ejection fraction (HFrEF).


METHODS
The survey comprised 22 questions and was published on the SurveyMonkey platform.


RESULTS
A total of 177 cardiologists (mean age: 39.5 years; 73.3% male) participated in the survey. Of these, 38.7% worked in a training and research hospital, and 10.2% were specialists in HF. The threshold EF value to define HFrEF was ≤ 40% for 80.1% of the cardiologists. While 52.6% of physicians considered angiotensin receptor-neprilysin inhibitor (ARNi) treatment the most effective medication for HF, 62.7% would initiate HF treatment with an angiotensin-converting enzyme inhibitor (ACEi) instead of ARNi due to reimbursement and cost issues. More than half of the cardiologists (52.3%) stated that adding another class of HF medication is more important than up-titrating those already prescribed. Although 69.5% of the study participants indicated prescribing all four classes of HF medications during the initial hospitalization is feasible, most cardiologists preferred a sequential approach starting with ACEi/ARNi, followed by beta-blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter 2 inhibitors (SGLT2i).


CONCLUSION
This survey highlights significant discrepancies between guideline recommendations and the real-life clinical practice of cardiologists in Türkiye. These results suggest that there is a need for organized action by healthcare providers to improve the implementation of guideline recommendations.

Keywords: Guideline, heart failure, recommendation, treatment

Corresponding Author: Umut Kocabaş, Türkiye
Manuscript Language: English
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Kocabaş, U., Özçalık, E., Kıvrak, T., Altın, C., & Türk, U. Ö. (2024). Clinical Management Strategies of Cardiologists in Heart Failure with Reduced Ejection Fraction in Türkiye. Turk Kardiyol Dern Ars, 52(8), 581-589. https://doi.org/10.5543/tkda.2024.32050.
Kocabaş U, Özçalık E, Kıvrak T, Altın C, Türk UÖ. Clinical Management Strategies of Cardiologists in Heart Failure with Reduced Ejection Fraction in Türkiye. Turk Kardiyol Dern Ars. 2024 December;52(8):581-589. doi:10.5543/tkda.2024.32050.
Kocabaş U, Özçalık E, Kıvrak T, et al. Clinical Management Strategies of Cardiologists in Heart Failure with Reduced Ejection Fraction in Türkiye. Turk Kardiyol Dern Ars. 2024;52(8):581-589. doi:10.5543/tkda.2024.32050.
Kocabaş, Umut et al. "Clinical Management Strategies of Cardiologists in Heart Failure with Reduced Ejection Fraction in Türkiye." Turk Kardiyol Dern Ars vol. 52,8 (2024): 581-589. doi:10.5543/tkda.2024.32050.
Kocabaş, Umut, Emre Özçalık, Tarık Kıvrak, Cihan Altın and Uğur Önsel Türk "Clinical Management Strategies of Cardiologists in Heart Failure with Reduced Ejection Fraction in Türkiye." Turk Kardiyol Dern Ars 52, no. 8 (2024): 581-589. https://doi.org/10.5543/tkda.2024.32050.
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