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1-104 TSC Abstracts/ORALS October 20-23, 2016 Heart Failure

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1-104 TSC Abstracts/ORALS October 20-23, 2016 Heart Failure TSC Abstracts/ORALS Anatol J Cardiol 2016; 16 (Suppl 1): 1-104 October 20-23, 2016 1 Heart failure Heart failure OP-001 OP-002 Use of tolvaptan in patients hospitalized for worsening chronic heart failure Influenza vaccine reduces recurrent hospitalizations in heart failure with refractory hyponatremia outpatients Saim Sağ1, Aysel Aydın Kaderli1, Abdülmecit Yıldız2, Bülent Özdemir1, İbrahim Baran1, Hakkı Kaya, Osman Beton, Mehmet Birhan Yılmaz, On Behalf Of TREAT HF Investigators 1 1 3 Sümeyye Güllülü , Ali Aydınlar , Yüksel Çavuşoğlu Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas 1 Department of Cardiology, Uludağ University Faculty of Medicine, Bursa Background and Aim: Influenza is a contagious human respiratory virus, seen worldwide and flu, caused by 2 Department of Internal Diseases, Uludağ University Faculty of Medicine, Bursa this virus is a significant health problem.The risk of infection, related to influenza and associated complica- 3 Department of Cardiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir tions is high also in patients with heart failure (HF).The current study aimed to evaluate the influence of Background and Aim: Heart failure (HF), as a clinical state of volume overload in both intravascular and regular annual influenza vaccinations on cardiovascular (CV) death and heart failure-related hospitaliza- extracellular spaces, is a major public health problem leading causes of hospital admissions in the world. tions (HFrH) in stable Heart failure with reduced ejection fraction (HFrEF) outpatients. These patients commonly have a history of progressive volume retention with hyponatremia manifested by Methods: Turkish research team-HF (TREAT-HF) is a network that has been undertaking multicenter, obser- an increase in body weight, leading to worsening symptoms requiring hospitalization. The aim of this study vational cohort studies in HF. This study is a subgroup analysis of TREAT-HF outpatient cohorts that consid- was to assess efficacy and safety of tolvaptan for severe hyponatremia (SH) in hypervolemic HF patients ered a questionnaire asking influenza vaccination status and also had available follow up data. A total of in daily clinical practice. 656 patients with available follow up data for CV death and HFrH including recurrent hospitalization were Methods: A database for patients with severe hyponatremia (SH) hospitalized for worsening HF with volume included in the study. Patients were classified into two groups as those who received regular influenza vac- overload between November 2014 and November 2015 that had tolvaptan added to standard treatments was cination (40%) and those who did not receive vaccination. retrospectively reviewed. SH was defined as a serum sodium concentration ≤125 mEq L–1. The database Results: During follow-up of a mean 15±6 months, 113 (18%) patients had CV death, 471 (72%) patients had included demographic, clinical, laboratory, and echocardiographic findings at admission, and numerous out- at least one HFrH. CV death rate was similar in both groups of patients (16% vs 19%, 0.37), whereas, HFrH come measures for oral tolvaptan treatment used to assess its efficacy and safety. and recurrent HFrH were significantly less frequently encountered in patients who received regular in- Results: The study included 56 hypervolemic HF patients with SH (25 female and 31 male) with a mean fluenza vaccination than who did not receive (43% vs 92% and 16% vs 66%, p<0.001, respectively). In the age of 66 years. All patients received oral tolvaptan 15 mg o. d. for SH for a mean 3.2 d. Sodium and potas- multivariate Cox proportional-hazards model with forward stepwise method; vaccination status (HR 0.30, sium concentrations, fluid intake, and the urine volume increased significantly (p<0.0001, p=0.037, p<0.0001, 95%CI 0.17-0.51, p<0.001), graduation from university (HR 0.35, 95%CI: 0.17-0.72, p=0.004), poor NYHA III-IV and p<0.0001, respectively), whereas the furosemide dosage, body weight, heart rate, systolic and dias- functional status (HR: 2.17, 95%CI: 1.46-3.24, p<0.001), hemoglobin level (HR 0.88, 95%CI: 0.80-0.97, p=0.003), tolic blood pressure, and New York Heart Association (NYHA) functional class decreased significantly in neutrophil count (HR 1.17, 95%CI: 1.09-1.26, p<0.001), being on the target dose of ACEI/ARB (HR 0.39, 95%CI: response to tolvaptan treatment (p<0.0001, p<0.0001, p=0.001, p<0.049, p<0.009, and p=0.001, respectively), 0.23-0.68, p=0.001) and being on the target dose of Beta blocker (HR 0.54, 95%CI: 0.33-0.87, p=0.012) remained without a rise in the serum creatinine or urea concentrations. Thirst (14.3%), dry mouth (14.3%), and muscle independently associated with the risk of recurrent HFrH following adjustment; for the variables found to cramp (12.5%) were the most common side effects. be statistically significant in the univariate analysis and for the variables found to be significantly different Conclusions: The findings of this small-scale, retrospective, single-center study the first such study to between those receiving regular influenza vaccination or not include a Turkish population show that short-term treatment with low-dose tolvaptan added to standard Conclusions: It seems that regular influenza vaccination does not influence CV deaths; however, it decreas- treatment for SH in hypervolemic HF patients was well tolerated and effectively corrected SH, with few es HFrH including recurrent ones in HFrEF outpatients. major adverse effects. Figure 1. Kaplan Meier Curve for recurrent heart failure related hospitalization. Figure 1. Change in the mean serum sodium, potassium, creatinine, and urea concentrations from admis- Heart failure sion to discharge. OP-003 Ivabradine treatment is associated with uptitration of chronic guidelines directed medications Hakkı Kaya, Hasan Yücel, Mehmet Birhan Yılmaz, On Behalf Of Treat Hf Investigators Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas Background and Aim: Chronic heart failure with reduced ejection fraction (HFREF) is a progressive disease with considerable success of overall management. However, ivabradine is an agent which is being sug- gested by ESC and has recently been accepted by FDA. We aimed to investigate the association between ıvabradin using and other guideline directed medications using. Methods: Turkish Research Team-HF (TREAT-HF) network has been testing a questionnaire to investigate several aspects of HFREF outpatients including medications. TREAT-HF 1 and 2 cohorts were recorded in 2013 and 2014 overall reaching 975 outpatients with HFREF out of 17 HF centers. In the whole group, ivabra- dine data were recorded in 884 HFREF patients Results: Patients who were on ivabradine stated more frequently that they take their medications regularly without interrruption (94% vs 86%, p=0.039) compared to those who were not on ivabradine. However, pa- tients who were on ivabradine were less likely to be on beta blockers compared to those who were not (83% vs 92%, p=0.003), though, patients who were on ivabradine were more likely to reach target doses of beta blockers compared to those who were not (5% vs 16%, p=0.030). Furthermore, patients who were on ivabra- Figure 2. Change in the mean concomitant furosemide dosage, fluid intake, urine volume and body weight dine were more likely to receive carvedilol as a beta blocker compared to those who were not on ivabradine from admission to discharge. (53% vs 39%, p=0.009). With regard to ACEinh/ARB use, patients who were on ivabradine were more likely on ACEinh/ARBs (88% vs 76%, p=0.005), and also were more likely on target doses of ACEinh/ARBs (25% vs 17%, p=0.034). In 223 patients with available ivabradine data, CV mortality data with a mean follow up of 12±6 months were available. In this group, patients on ivabradine had less CV mortality on follow up compared to those who were not on ivabradine (4% vs 22%, p=0.007). Conclusions: It seems ivabradine use in HFREF outpatients was associated with better implementation of guideline directed medications, particularly carvedilol. TSC Abstracts/ORALS 2 October 20-23, 2016 Anatol J Cardiol 2016; 16 (Suppl 1): 1-104 Heart failure Other OP-004 OP-006 Potential clinical application of LCZ696 in real life clinical practice in heart Predictors of long-term mortality and frequent re-hospitalization in acute failure patients who are receiving ACEİ or ARB: decompensated heart failure with kidney dysfunction treated with renin Results from REALITY HF Study angiotensin system blockers: A competing risk regression analysis Yüksel Çavuşoğlu1, Ömer Kozan2, Serdar Küçükoğlu3, Ahmet Temizhan4 Canan Baydemir1, Dilek Ural2, Kurtuluş Karaüzüm3, Sibel Balcı1, Onur Argan4, 5 6 6 1Department of Cardiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir İrem Karaüzüm , Güliz Kozdağ , Ayşen A. Ağır 2Department of Cardiology, Dokuz Eylül University Faculty of Medicine, İzmir 1Department of Biostatistics and Medical Informatics, Kocaeli University Faculty of Medicine, Kocaeli 3Department of Cardiology, İstanbul University Institute of Cardiology, İstanbul 2Department of Cardiology, Koç University Faculty of Medicine, İstanbul 4Department of Cardiology, Ankara Türkiye Yüksek Training and Research Hospital, Ankara 3Department of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli 4 Background and Aim: LCZ696 (an ARNİ) is expected to change clinical practice because of overwhelming İzmit State Hospital, Kocaeli 5 benefit of LCZ696 over enalapril in heart failure (HF). However, potential clinical use of LCZ696 in real life Department of Cardiology, Isparta State Hospital, Isparta 6 clinical practice is unknown. REALITY HF data were analyzed to evaluate potential clinical application of Department of Cardiology, Kocaeli University Faculty of Medicine, Kocaeli LCZ696 in real life clinical practice in HF patients who are receiving ACEİ or ARB. Background and Aim: Renin angiotensin system (RAS) blockers have been shown to improve clinical out- Methods: REALITY HF was a multicenter, observational, national registry designed to evaluate HF patients’ come in acute decompensated heart failure (ADHF) with renal dysfunction.
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