Table 1. Characteristic features of the patients

Age (year�SD) 57,21�12,45

Female (%) 66,9

Hypertension (%) 51,2

Hyperlipidemia (%) 31

Diabetes (%) 16,9

Coronary Heart Disease (%) 23,4

Heart Failure (%) 7,3

Chronic Kidney Disease (%) 19,4

HASBLED score (n�SD) 1,54�1,08

Warfarin Dose (mg/week�SD) 33,33�15,38

Mean TTR (%) 55,92�27,84

Patients whose TTR > %60 (%) 48

History of thromboembolic or bleedingcomplications (%)

49,6

Warfarin usage (year�SD) 7,48�6,18

INR checking per year 10,02�3,80

INR: _Internatiõonal Normalized Ratio, SD: Standart deviation, TTR: Time in Therapeutic Range

Table 2. Characteristic features of the patients according to warfarinindications

Characteristic features of the patients

Prosthetic

valve Valvular AF Nonvalvular AF p value

Age (year�SD) 52,96�11,24 57,97�11,96 68,82�7,77 0,013

Female (%) 64,8 97,0 55,4 <0,001

Hypertension (%) 40,3 45,5 85,7 <0,001

Diabetes (%) 11,9 27,3 25,0 o,019

Coronary Heart Disease (%) 20,1 12,1 39,3 0,004

Heart Failure (%) 20,1 3,0 16,1 0,014

HASBLED score (n�SD) 1,42�0,9 1,36�1,19 2,00�1,17 0,030

Warfarin Dose (mg/week�SD) 35,58�16,90 31,68�11,05 27,92�11,18 0,004

Warfarin usage (year�SD) 9,49�6,58 3,82�2,47 3,91�3,31 <0,001

History of thromboembolic or bleeding

complications (%)

56,0 39,4 37,5 0,027

INR checking per year 9,99�3,94 10,52�4,10 9,82�3,19 0,558

Mean TTR (%) 55,24�28,53 61,48�25,90 54,59�27,01 0,668

Patients whose TTR >%60 (%) 47,2 51,5 48,2 0,901

AF: Atrial fibrillation, INR: _Internatiõonal Normalized Ratio, SD: Standart deviation, TTR: Timein Therapeutic Range

Table 3. Mean TTR and effective TTR according to weekly warfarin dose

weekly warfarin

dose

Mean TTR*

(%�SD)

TTR** (%)

<%60

TTR** (%)

�%60

<15 mg 53,76�28,82 57,1 42,9

�15 mg 56,12�27,80 %51,5 %48,5

TTR: Time in Therapeutic Range * p:0,623, ** p:0,711

Table 4. Mean TTR and TTR efficacy versus complication history

Complication

History

Mean TTR*

(%�SD)

TTR** (%)

<%60

TTR** (%)

�%60

Absent 55,91�27,8 52,8 47,2

Present 55,93�27,9 51,2 48,8

*p:0,995, ** p:0,803 SD: Standart deviation, TTR: Time in Therapeutic Range

POSTERS

PP-116

Factors That Affect Pulmonary Artery Pressure in Scleroderma Patients withPulmonary Hypertensõon

U�gur Nadir Karakulak1, Naresh Maharjan1, Elifcan Alada�g2, Levent Kılıç2,Ali Akdo�gan2, Ergün Barıs Kaya1, Lale Tokgözo�glu11Hacettepe University Faculty of Medicine Department of Cardiology, Ankara,2Hacettepe University Faculty of Medicine Department of Rheumatology, Ankara

Introductıon: Despite improved treatment modalities, the prognosis of pulmonaryhypertension due to connective tissue disease such as scleroderma is very high. In this

C128 JACC Vo

study, we evaluate factors that affect pulmonary artery pressure in sclerodermapatients with pulmonary hypertensionMaterıals-Methods: 24 scleroderma patients with pulmonary hypertension wereincluded in this study. Detailed history was taken, physical examination and elec-trocardiography performed and pulmonary hypertension was diagnosed by trans-thoracic echocardiography along with right heart catheterization during whichsystolic, diastolic and mean pulmonary artery pressures were measured. High reso-lution tomography was used to diagnose interstitial pulmonary disease and inflam-matory markers and autoantibodies were also measured. Factors that can be affectedon pulmonary artery pressure were evaluated with Spearman's rho test and Coxregression analysis.Results: A total of 24 patients, 19 were women (79%). In univariate analysis, there isa positive correlation between pulmoary artery pressure and body mass index, rightventricular diastolic diameter and BNP levels and also there is a negative correlationbetween pulmonary artery pressure and presence of hypertension and white blood cellcount. In multivariate analysis, there is positive correlation between only rightventricular diastolic diameter (r¼0,649, p<0,0001) and negative correlation betweenpresence of hypertension (r¼-0,502, p¼0,002).Dıscussıon: Pulmonary hypertension accompanying scleroderma seriously decreasesthe survival of these patients. Pulmoary artery pressure is an important factor in thesepatients’ clinical course. Thus patients who have more elevated pulmonary arterypressure may be follewed earlier, more intense and with combination therapy. In thisstudy, it was shown that there are strong correlations between right ventricular dia-stolic diameter, presence of hypertension and pulmonary artery pressure in sclero-derma patients with pulmonary hypertension.

PP-117

A New Electrocardiographic Parameter in Scleroderma Patients with andWithout Pulmonary Hypertension: Tp-E/Qtc Ratıo

U�gur Nadir Karakulak1, Naresh Maharjan1, Elifcan Alada�g2, Levent Kılıç2,Ali Akdo�gan2, Ergün Barıs Kaya1, Lale Tokgözo�glu11Hacettepe University Faculty of Medicine Department of Cardiology, Ankara,2Hacettepe University Faculty of Medicine Department of Rheumatology, Ankara

Introductıon: Scleroderma is a chronic, autoimmune disease that leads to fibrosis ofthe skin and visceral organs. Tp-e/QTc ratio, that reveals transmural repolarization andarrhythmogenesis, is a new, highly reliable parameter, that can be used to determineindividuals with a high risk of ventricular arrhythmias. In this study, Tp-eQTc ratiowas calculated in scleroderma patients with and without pulmonary hypertension andthe difference between the two groups as well as the relation of this parameter withmortality was sought for.Materıals-Methods: A total of 160 scleroderma patients were includes in this study.From the 12-derivation ECG of each patient, the interval between the peak (Tp) andthe end of the T wave (Te) was calculated and the difference was used to obtain a ratiowith QTc. Independent t-test was used to determine difference between groups whileCox regression analysis was used to determine its significance as a predictor ofmortality.Results: Pulmonary hypertension was present in 15% of the patients. The Tp-e/QTcratio in scleroderma patients without pulmonary hypertension was 28.3�4.9 and thatin patients with pulmonary hypertension was 31.4�5.7. The difference between thetwo groups was statistically significant (p¼0.007). This ratio was found to bea predictor of mortality in those with pulmonary hypertension (p¼0.029) but it did notpredict mortality in those without pulmonary hypertension (p¼0.489). The risk ofmortality was found to be increased in patients with a Tp-e/QTc ratio > 0.35 ascompared to those with a ratio of <0.35 (Fig. 1).Dıscussıon: Non-invasive methods of determining arrhythmia risk has been receivingincreased attention in recent years. Tp-e/QTc ratio is a new parameter that predictsarrhythmia risk in different spectrum of diseases. In this study, presence of pulmonaryhypertension in scleroderma patients was found to be a risk factor for cardiacarrhythmias and a significant correlation was found between this simple and easy ECGparameter and mortality. Patients with a high Tp-e/QTc ratio must be closely andcarefully followed-up for cardiac complications.

l 62/18/Suppl C j October 26–29, 2013 j TSC Abstracts/POSTERS