Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study

Objective: Despite recommendations from heart failure guidelines on the use of pharmacologic and device therapy in patients with heart failure with reduced ejection fraction (HFrEF), important inconsistencies in guideline adherence persist in practice. The aim of this study was to assess ad-herence to guideline-directed medical and device therapy for the treatment of patients with chronic HFrEF (left ventricular ejection fraction ≤40%).Methods: The Adherence to guideline-directed medical and device Therapy in outpAtients with HFrEF (ATA) study is a prospective, multicenter, observational study conducted in 24 centers from January 2019 to June 2019.Results: The study included 1462 outpatients (male: 70.1%, mean age: 67±11 years, mean LVEF: 30%±6%) with chronic HFrEF. Renin–angiotensin system (RAS) inhibitors, beta-blockers, mineralocorticoid receptor antagonists (MRAs), and ivabradin were used in 78.2%, 90.2%, 55.4%, and 12.1% of patients, respectively. The proportion of patients receiving target doses of medical treatments was 24.6% for RAS inhibitors, 9.9% for beta-blockers, and 10.5% for MRAs. Among patients who met the criteria for implantable cardioverter–defibrillator (ICD) and cardiac resynchro-nization therapy (CRT), only 16.9% of patients received an ICD (167 of 983) and 34% (95 of 279) of patients underwent CRT (95 of 279).Conclusion: The ATA study shows that most HFrEF outpatients receive RAS inhibitors and beta-blockers but not MRAs or ivabradin when the medical reasons for nonuse, such as drug intolerance or contraindications, are taken into account. In addition, most eligible patients with HFrEF do not receive target doses of pharmacological treatments or guideline-recommended device therapy. (Anatol J Cardiol 2020; 24: 32-40)

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APA	Kocabas U, ozmen t, ÖZTEKİN G, TANIK V, özdemir i, KAYA E, Yüce E, Avci Demir F, DOĞDUŞ M, ALTINSOY M, ÜSTÜNDAĞ S, ozyurtlu f, Karagöz U, karakus a, Urgun Ö, Sinan U, MUTLU İ, ŞEN T, ASTARCIOĞLU M, KINIK M, ÖZDEN TOK Ö, Uygur B, Yeni M, ALAN B, DALGIÇ Ö, sarıtürk ç, Altay H, Pehlivanoğlu S (2020). Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. , 32 - 40. 10.14744/AnatolJCardiol.2020.91771
Chicago	Kocabas Umut,ozmen tarik,ÖZTEKİN Gülsüm Meral Yılmaz,TANIK VEYSEL OZAN,özdemir ibrahim halil,KAYA Ersin,Yüce Elif ilkay,Avci Demir Fulya,DOĞDUŞ Mustafa,ALTINSOY Meltem,ÜSTÜNDAĞ Songül,ozyurtlu ferhat,Karagöz Uğur,karakus alper,Urgun Örsan Deniz,Sinan Umit Yasar,MUTLU İnan,ŞEN Taner Zafer,ASTARCIOĞLU Mehmet Ali,KINIK Mustafa,ÖZDEN TOK Özge,Uygur Begum,Yeni Mehtap,ALAN Bahadır,DALGIÇ Özden Onur,sarıtürk çağla,Altay Hakan,Pehlivanoğlu Seçkin Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. (2020): 32 - 40. 10.14744/AnatolJCardiol.2020.91771
MLA	Kocabas Umut,ozmen tarik,ÖZTEKİN Gülsüm Meral Yılmaz,TANIK VEYSEL OZAN,özdemir ibrahim halil,KAYA Ersin,Yüce Elif ilkay,Avci Demir Fulya,DOĞDUŞ Mustafa,ALTINSOY Meltem,ÜSTÜNDAĞ Songül,ozyurtlu ferhat,Karagöz Uğur,karakus alper,Urgun Örsan Deniz,Sinan Umit Yasar,MUTLU İnan,ŞEN Taner Zafer,ASTARCIOĞLU Mehmet Ali,KINIK Mustafa,ÖZDEN TOK Özge,Uygur Begum,Yeni Mehtap,ALAN Bahadır,DALGIÇ Özden Onur,sarıtürk çağla,Altay Hakan,Pehlivanoğlu Seçkin Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. , 2020, ss.32 - 40. 10.14744/AnatolJCardiol.2020.91771
AMA	Kocabas U,ozmen t,ÖZTEKİN G,TANIK V,özdemir i,KAYA E,Yüce E,Avci Demir F,DOĞDUŞ M,ALTINSOY M,ÜSTÜNDAĞ S,ozyurtlu f,Karagöz U,karakus a,Urgun Ö,Sinan U,MUTLU İ,ŞEN T,ASTARCIOĞLU M,KINIK M,ÖZDEN TOK Ö,Uygur B,Yeni M,ALAN B,DALGIÇ Ö,sarıtürk ç,Altay H,Pehlivanoğlu S Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. . 2020; 32 - 40. 10.14744/AnatolJCardiol.2020.91771
Vancouver	Kocabas U,ozmen t,ÖZTEKİN G,TANIK V,özdemir i,KAYA E,Yüce E,Avci Demir F,DOĞDUŞ M,ALTINSOY M,ÜSTÜNDAĞ S,ozyurtlu f,Karagöz U,karakus a,Urgun Ö,Sinan U,MUTLU İ,ŞEN T,ASTARCIOĞLU M,KINIK M,ÖZDEN TOK Ö,Uygur B,Yeni M,ALAN B,DALGIÇ Ö,sarıtürk ç,Altay H,Pehlivanoğlu S Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. . 2020; 32 - 40. 10.14744/AnatolJCardiol.2020.91771
IEEE	Kocabas U,ozmen t,ÖZTEKİN G,TANIK V,özdemir i,KAYA E,Yüce E,Avci Demir F,DOĞDUŞ M,ALTINSOY M,ÜSTÜNDAĞ S,ozyurtlu f,Karagöz U,karakus a,Urgun Ö,Sinan U,MUTLU İ,ŞEN T,ASTARCIOĞLU M,KINIK M,ÖZDEN TOK Ö,Uygur B,Yeni M,ALAN B,DALGIÇ Ö,sarıtürk ç,Altay H,Pehlivanoğlu S "Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study." , ss.32 - 40, 2020. 10.14744/AnatolJCardiol.2020.91771
ISNAD	Kocabas, Umut vd. "Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study". (2020), 32-40. https://doi.org/10.14744/AnatolJCardiol.2020.91771

APA	Kocabas U, ozmen t, ÖZTEKİN G, TANIK V, özdemir i, KAYA E, Yüce E, Avci Demir F, DOĞDUŞ M, ALTINSOY M, ÜSTÜNDAĞ S, ozyurtlu f, Karagöz U, karakus a, Urgun Ö, Sinan U, MUTLU İ, ŞEN T, ASTARCIOĞLU M, KINIK M, ÖZDEN TOK Ö, Uygur B, Yeni M, ALAN B, DALGIÇ Ö, sarıtürk ç, Altay H, Pehlivanoğlu S (2020). Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. The Anatolian Journal of Cardiology, 24(1), 32 - 40. 10.14744/AnatolJCardiol.2020.91771
Chicago	Kocabas Umut,ozmen tarik,ÖZTEKİN Gülsüm Meral Yılmaz,TANIK VEYSEL OZAN,özdemir ibrahim halil,KAYA Ersin,Yüce Elif ilkay,Avci Demir Fulya,DOĞDUŞ Mustafa,ALTINSOY Meltem,ÜSTÜNDAĞ Songül,ozyurtlu ferhat,Karagöz Uğur,karakus alper,Urgun Örsan Deniz,Sinan Umit Yasar,MUTLU İnan,ŞEN Taner Zafer,ASTARCIOĞLU Mehmet Ali,KINIK Mustafa,ÖZDEN TOK Özge,Uygur Begum,Yeni Mehtap,ALAN Bahadır,DALGIÇ Özden Onur,sarıtürk çağla,Altay Hakan,Pehlivanoğlu Seçkin Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. The Anatolian Journal of Cardiology 24, no.1 (2020): 32 - 40. 10.14744/AnatolJCardiol.2020.91771
MLA	Kocabas Umut,ozmen tarik,ÖZTEKİN Gülsüm Meral Yılmaz,TANIK VEYSEL OZAN,özdemir ibrahim halil,KAYA Ersin,Yüce Elif ilkay,Avci Demir Fulya,DOĞDUŞ Mustafa,ALTINSOY Meltem,ÜSTÜNDAĞ Songül,ozyurtlu ferhat,Karagöz Uğur,karakus alper,Urgun Örsan Deniz,Sinan Umit Yasar,MUTLU İnan,ŞEN Taner Zafer,ASTARCIOĞLU Mehmet Ali,KINIK Mustafa,ÖZDEN TOK Özge,Uygur Begum,Yeni Mehtap,ALAN Bahadır,DALGIÇ Özden Onur,sarıtürk çağla,Altay Hakan,Pehlivanoğlu Seçkin Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. The Anatolian Journal of Cardiology, vol.24, no.1, 2020, ss.32 - 40. 10.14744/AnatolJCardiol.2020.91771
AMA	Kocabas U,ozmen t,ÖZTEKİN G,TANIK V,özdemir i,KAYA E,Yüce E,Avci Demir F,DOĞDUŞ M,ALTINSOY M,ÜSTÜNDAĞ S,ozyurtlu f,Karagöz U,karakus a,Urgun Ö,Sinan U,MUTLU İ,ŞEN T,ASTARCIOĞLU M,KINIK M,ÖZDEN TOK Ö,Uygur B,Yeni M,ALAN B,DALGIÇ Ö,sarıtürk ç,Altay H,Pehlivanoğlu S Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. The Anatolian Journal of Cardiology. 2020; 24(1): 32 - 40. 10.14744/AnatolJCardiol.2020.91771
Vancouver	Kocabas U,ozmen t,ÖZTEKİN G,TANIK V,özdemir i,KAYA E,Yüce E,Avci Demir F,DOĞDUŞ M,ALTINSOY M,ÜSTÜNDAĞ S,ozyurtlu f,Karagöz U,karakus a,Urgun Ö,Sinan U,MUTLU İ,ŞEN T,ASTARCIOĞLU M,KINIK M,ÖZDEN TOK Ö,Uygur B,Yeni M,ALAN B,DALGIÇ Ö,sarıtürk ç,Altay H,Pehlivanoğlu S Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study. The Anatolian Journal of Cardiology. 2020; 24(1): 32 - 40. 10.14744/AnatolJCardiol.2020.91771
IEEE	Kocabas U,ozmen t,ÖZTEKİN G,TANIK V,özdemir i,KAYA E,Yüce E,Avci Demir F,DOĞDUŞ M,ALTINSOY M,ÜSTÜNDAĞ S,ozyurtlu f,Karagöz U,karakus a,Urgun Ö,Sinan U,MUTLU İ,ŞEN T,ASTARCIOĞLU M,KINIK M,ÖZDEN TOK Ö,Uygur B,Yeni M,ALAN B,DALGIÇ Ö,sarıtürk ç,Altay H,Pehlivanoğlu S "Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study." The Anatolian Journal of Cardiology, 24, ss.32 - 40, 2020. 10.14744/AnatolJCardiol.2020.91771
ISNAD	Kocabas, Umut vd. "Adherence to guideline-directed medical and device Therapy in outpAtients with heart failure with reduced ejection fraction:The ATA study". The Anatolian Journal of Cardiology 24/1 (2020), 32-40. https://doi.org/10.14744/AnatolJCardiol.2020.91771