Background: Heart failure (HF) is a common condition that affects 1-3% of the general population. Its prevalence exhibits notable international and intranational disparities, partly explained by socioeconomic status, religion, ethnic diversity, and geographic factors. A comprehensive understanding of the epidemiological symptoms of HF in different regions of Turkiye has yet to be revealed. Aims: To examine epidemiological data from 2016 to 2022, focusing on crucial patient characteristics and geographical regions, to determine the incidence and prevalence of HF in Turkiye across seven diverse geographical regions.Study Design: A nationwide population-based retrospective cohort study.Methods: The comprehensive National Electronic Database of the Turkish Ministry of Health was used in this study to obtain data that covers the whole Turkish population from January 1, 2016, to December 31, 2022. The International Classification of Diseases-10 (ICD-10) codes were used to identify adults with HF (n = 2,701,099) and associated comorbidities. Turkiye is divided into seven geographically distinct regions. Epidemiological characteristics and survival data of these regions were analyzed separately. All-cause mortality was set as the primary outcome. Results: In , the total estimated prevalence of adult patients with HF is 2.939%, ranging from 2.442% in Southeastern Anatolia to 4.382% in the Black Sea Region. Except for the Eastern Anatolia Region, the three most often reported comorbidities were hypertension, dyslipidemia, and anxiety disorders. The rates of prescribing guideline-directed medical therapy (GDMT) for HF and other medications varied significantly. GDMT prescription rates were lowest in the Eastern Anatolia Region (82.6% for beta-blockers, 48.7% for RASi, 31.8% for mineralocorticoid receptor antagonists, and 9.4% for SGLT2i). The Mediterranean and Aegean regions had the highest median N-terminal brain natriuretic peptide (NT-proBNP) levels of 1,990,0 pg/ml (518.0-6,636,0) and 1,441,0 pg/ml (363.0-5,000,0), respectively. From 2016 to 2022, 915,897 (33.9%) of 2,701,099 patients died. The Eastern Anatolia Region had the lowest all-cause mortality rate of 26.5%, whereas the Black Sea Region had the highest all-cause mortality rate of 35.3%.Conclusion: Our real-world analysis revealed geographic disparities in HF characteristics, such as decreased mortality in socioeconomically challenged regions. Higher stress susceptibility in developed regions may increase the likelihood of adverse outcomes.

Objective: The long-term durability of transcatheter aortic bioprosthetic valves continues to be a major concern. Standardized criteria of the structural valve deterioration (SVD) and bioprosthetic valve failure (BVF) have recently been defined. Limited studies have evaluated the longterm durability of transcatheter aortic valve implantation (TAVI) according to these new definitions. We aim to analyze the durability of TAVI beyond 5 years and to report the frequency of SVD and BVF. Methods: A total of 89 patients who had undergone TAVI and had theoretically completed at least 5 years after the procedure were included. Either a Medtronic CoreValve or an Edwards SAPIEN XT valve were implanted in the patients. New standardized definitions were used to evaluate SVD and BVF. Results: The mean age of the patients was 78.70 +/- 6.95 years. SVD occured in 4 (4.5%) patients during 6 years of follow-up. Severe SVD was observed in 2 patients (2.2%), and these patients had the New York Heart Association class II symptoms. Both patients with severe SVD also met the criteria of BVF. Moderate SVD was observed in 2 patients (2.2%), and these patients had no valve-related symptoms. Of the 4 SVD cases, 2 were associated with increased mean transaortic gradients, whereas the remaining 2 cases were associated with intraprosthetic aortic regurgitation. All patients with SVD are still alive, and none of them have required aortic valve reintervention. Conclusion: Although first-generation TAVI devices were used, we determined the low rate of SVD and BVF at the 6-year follow-up. It may be suggested that there is no major concern associated with TAVI even with first-generation devices regarding long-term durability.

Background: Frontal plane QRS‐T angle (fQRS‐T) and platelet‐to‐lymphocyte ratio (PLR) are highly important parameters that well‐predict unfavorable outcomes in patients with ST‐elevated myocardial infarction (STEMI).There are limited data on the predictive significance of ischemic cardiomyopathy (I‐CMP) from the combination of fQRS‐T and PLR in STEMI, compared to using fQRS‐T and PLR alone.Aim: We aimed to evaluate the ability of the combination of fQRS‐T and PLR routinely obtained on admission to identify STEMI patients at risk of I‐CMP.Method: Six hundred and thirty‐eight consecutive patients with STEMI who underwent primary percutaneous coronary intervention between 2018 and 2021 were included. The assessment of I‐CMP was conducted through two‐dimentional (2D)‐echocardiography 6 weeks post‐STEMI and I‐CMP was defined as a left ventricular ejection fraction (LVEF) of 50% or less. Multivariate logistic regression analysis and receiver operating curve (ROC) analysis were performed to predict the development of I‐CMP.Results: In ROC analysis, the cut‐off values of fQRS‐T and PLR for best predicting I‐CMP were 66.72° and 101.23, respectively. The model using the combination of two markers was the most powerful predictor of I‐CMP risk (OR: 3.183, 95% CI: 1.971–5.139, p = .001) when included in a single variable such as high fQRS‐T or high PLR (OR: 1.422, 95% CI: 0.870–0.232, p = .160). Additionally, the concomitant presence of high fQRS‐T and high PLR exhibited the highest specificity (77%) for I‐CMP relative to the individual presence of high fQRS‐T (66%) or PLR (49%).Conclusion: The combination of fQRS‐T and PLR, which is a simple and cost‐effective risk assessment, may serve as a more reliable prognosticator for I‐CMP as opposed to the use of fQRS‐T and PLR alone for STEMI.