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Öğe 2016 ESC and ACC/AHA/HFSA heart failure guideline updates: Changes, similarities, differences, and unresolved isssues(TURKISH SOC CARDIOLOGY, 2016) Sari, Ibrahim; Cavusoglu, Yuksel; Temizhan, Ahmet; Yilmaz, Mehmet Birhan; Eren, Mehmet…Öğe A new technique for the detection of dry weight in hemodialysis patients: Estimated pulmonary capillary wedge pressure. A tissue Doppler imaging study(Soc Espanola Nefrologia Dr Rafael Matesanz, 2022) Yildiz, Gursel; Hur, Ender; Magden, Kemal; Candan, Ferhan; Kayatas, Mansur; Yildirim, Ibrahim; Yilmaz, Mehmet BirhanBackground and objective: Fluid overload is an important factor of morbidity and mortality in hemodialysis patients. Today correct determination of dry weight (DW) remains an important issue of hemodialysis practice. Within this context, it is subjected to new method searching. The objective of this study was to calculate estimated pulmonary capillary wedge pressure (ePCWP) with Tissue Doppler Imaging (TDI) in hemodialysis patients and to evaluate its correlation with the other volume markers and to evaluate whether it can be a new method for detection of DW. Materials and methods: Echocardiographic, hemodynamic, and biochemical volume markers of 41 hemodialysis patients were evaluated in the pre- and post-dialysis periods. Patients were divided into two groups based on ePCWP values (Group 1 ePCWP <20 mmHg, Group 2 ePCWP> 20 mmHg). Results: In the pre-dialysis period; parameters related to volume load including ePCWP, systolic blood pressure, mean arterial pressure, pulse pressure, left atrial diameter, left atrial volume, E/e, ratio and E/V-p ratio were statistically significantly higher in Gmup2 compared to Group1. On the other hand, strong correlations were found between pre-dialysis ePCWP and systolic blood pressure, mean arterial pressure, pulse pressure, NT-ProBNP, left atrial diameter, E/e ratio and E/V-p ratio. Conclusions: Strong correlations found between ePCWP which was calculated with TDI and the other volume markers both in pre-dialysis and post-dialysis periods. These findings can provide a significant contribution to routine evaluating of DW in hemodialysis patients. From this aspect, the prediction of ePCWP with TDI can be a new practical and reproducible method for the determination of DW. (C) 2021 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.Öğe Acute and long-term follow-up results of percutaneous mitral balloon valvuloplasty: A single-center study(AVES, 2011) Korkmaz, Şule; Demirkan, Burcu; Güray, Yeşim; Yilmaz, Mehmet Birhan; Aksu, Tolga; Şaşmaz, HaticeObjective: Percutaneous mitral balloon valvuloplasty (PMBV) is the method of choice in treatment of patients with hemodynamically significant mitral stenosis. We aimed to analyze acute and long-term clinical and echocardiographic consequences of PMBV. Methods: In this retrospective cohort study; 311 patients who underwent PMBV in our Cardiology Clinic at Türkiye Yüksek İhtisas Education and Research Hospital between January 2000 and March 2004 were evaluated for acute procedural outcomes and primary endpoints (death, rePMBV, mitral valve replacement (MVR)). All 311 patients were contacted by phone call or letter at least five years after the procedure. Of the 311 patients, 87 who defined NYHA class II-IV symptoms were invited for a control visit and detailed echocardiographic evaluation. Sixty-three patients out of 87 who completed follow-up were enrolled for long-term consequences. Those 63 patients were subclassified into two groups as those without any negative event (n=26) (Group 1) and those with mitral valve area (MVA) (<1.5 cm2), rePMBV or referral to MVR (n=37) (Group 2) on follow up to 6.4±1.6 years. Results: In the analysis of 311 patients, acute post procedural success, which was defined as mitral valve area (MVA) ?1.5 cm2 without severe mitral regurgitation, was 94% and was only associated with preprocedural MVA (p=0.008). In the logistic regression analysis, preprocedural MVA was the only independent parameter, associated with acute procedural success (Exp?=0.004, 95%CI 0.0001-0.234, p=0.008). In the longterm follow up of 63 patients, the patients with uneventful course (Group 1) had significantly higher MVA (p<0.001), lower mean (p=0.001) and peak (p<0.001) transmitral gradients immediately after the procedure when we compared to the patients in Group 2. It was also noticed that patients with at least 60% improvement in MVA experienced composite end point much less frequently compared to those with less than 60% improvement in MVA (5% vs. 30.4%, p=0.009). Kaplan-Meier analysis yielded significantly diverging cumulative survival curves for those with and without at least 60% improvement in MVA (p=0.003). Conclusion: Concerning long-term follow up data of patients undergoing PMBV in a single center, it seems only acute postprocedural MVA was significantly associated with long-term consequences. © Copyright 2011 by AVES Yayincilik Ltd.Öğe Acute Effects of Levosimendan and Dobutamine on QRS Duration in Patients with Heart Failure(ARQUIVOS BRASILEIROS CARDIOLOGIA, 2010) Yontar, Osman Can; Yilmaz, Mehmet Birhan; Yalta, Kenan; Erdem, Alim; Tandogan, IzzetBackground: Levosimendan is a novel inotropic agent that enhances cardiac contractility without increasing cellular calcium intake, so that it is not supposed to cause intracellular calcium overload and related arrhythmias. In patients with heart failure, prolonged QRS duration is associated with increased risk of mortality and sudden cardiac death. Structural changes in the left ventricle may lead to asynchronous contraction, causing conduction delay and a prolonged QRS on the surface electrocardiogram. Objective: We aimed to compare the acute effects of levosimendan and dobutamine on QRS duration in patients with severe heart failure and sinus rhythm. Methods: Sixty consecutive patients with ischemic heart failure were enrolled for the study and randomized into two groups for levosimendan (n=37) or dobutamine (n=23) infusions. 67.2 % were male; mean age was 66.4 +/- 9.2 years for all patients. Baseline QRS durations in levosimendan and dobutamine groups were, 120.44 +/- 23.82 ms vs 116.59 +/- 13.80 ms respectively. Baseline ejection fractions were both depressed (23.15 +/- 8.3% vs 24.56 +/- 7.5%). Results: In the levosimendan group, QRS duration shortened from baseline value to 116.47 +/- 24.56 msec (p=0.006), whereas dobutamine group showed no significant change (p=0.605). Both drugs caused an increase in ejection fraction, but only the levosimendan group showed significance (27.95 +/- 8.9% p=0.003 vs 26.67 +/- 7.6%, p=0.315). Conclusion: We suggest that the administration of levosimendan, not dobutamine, shortens QRS duration on the surface ECG, possibly by means of providing collective contraction in the left ventricle muscle fibers. The molecular basis of this effect remains to be clarified. (Arq Bras Cardiol 2010;95(6):738-742)Öğe Advanced heart failure and future of mechanical assist devices: a Consensus Report on Cardiology and Cardiovascular Surgery(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2016) Yilmaz, Mehmet Birhan; Akar, Ahmet Ruchan; Ekmekci, Ahmet; Nalbantgil, Sanem; Sade, Leyla Elif; Eren, Mehmet; Orhan, R. Gokcen; Ozbaran, Mustafa; Yagdi, Tahir; Kucuker, Seref Alp; Gurbuz, Ali; Tokgozoglu, LaleHeart failure is a progressive disease. A considerable portion of patients reach an advanced or terminal phase later or sooner, despite all of the developments in diagnosis, management, and follow-up and alternatives which can slow the disease process. As well as the palliative care of the patient in the terminal phase, definite recognition of the patient with advanced disease is vital for the consideration of therapeutic options in this patient population. Overall management and care of patients with heart failure obligates a collaboration of multiple disciplines. In addition, patients with advanced heart failure should be managed by a "heart team", as indicated by the guideline recommendations, since it requires a close communication and collaboration among cardiologists, cardiovascular surgeons, and other medical staff who are responsible for taking care of these patients. In Turkey, we have experienced physicians for managing patients with advanced heart failure. However, we are unlikely to be sufficient in the distribution of the centers and equal accessibility for all patients to therapeutic options. Hence, we still have more to do for the referral of eligible patients and patient circulation issues. This consensus report is developed to strengthen the connection between experienced and certified centers and the centers which take care of heart failure patients independent of the disease phase and other healthcare staff to increase awareness and to provide updated information for the current conditions of Turkey.Öğe After the GEMINI-ACS-1 trial(TURKISH SOC CARDIOLOGY, 2017) Yilmaz, Mehmet BirhanThe GEMINI-ACS-1 trial has recently been published. It was designed to test whether low dose rivaroxaban as an antithrombotic agent is as safe as aspirin in patients with acute coronary syndromes (ACS). The trial is important to set light to future of ACS management.Öğe Antithrombotic treatment patterns and stroke prevention in patients with atrial fibrillation in Turkey: Inferences from GARFIELD-AF registry(Turkish Soc Cardiology, 2019) Sayin, Begum Yetis; Okutucu, Sercan; Yilmaz, Mehmet Birhan; Ozdemir, Kurtulus; Aydinlar, Ali; Sahin, Durmus Yildiray; Altun, ArmaganObjective: The corner stone of atrial fibrillation therapy includes the prevention of stroke with less adverse effects. The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) study provided data to compare treatment strategies in Turkey with other populations and every-day practice of stroke prevention management with complications. Methods: GARFIELD-AF is a large-scale registry that enrolled 52,014 patients in five sequential cohorts at > 1.000 centers in 35 countries. This study was initiated to track the evolution of global anticoagulation practice, and to study the impact of NOAC therapy in AF. A total of 756 patients from 17 enrolling sites in Turkey were in cohort 4 and 5. Treatment strategies at diagnosis initiated by CHA(2)DS(2)-VASc score, baseline characteristics of patients, treatment according to stroke and bleeding risk profiles, and INR values were analyzed in cohorts. Additionally, event rates during the first year follow up were evaluated. Results: AF patients in Turkey were mostly seen in young women. Stroke risk according to the CHADS(2) score and CHA(2)DS(2)-VASc score compared with world data. The mean of risk score values, including HAS-BLED score were lower in Turkey than in the world data. The percentage of patients receiving FXa inhibitor with or without an antiplatelet usage was more than the other drug groups. All-cause mortality was higher in Turkey. Different form world data when HAS-BLED score was above 3, the therapy was mostly changed to antiplatelet drugs in Turkey. Conclusion: In addition to deficiencies in available treatment options, patient care and clinical outcomes of patients with AF, the data of GARFIELD-AF provide data from Turkey about therapeutic strategies and best practices.Öğe Aortic Intracardiac Echocardiography Guided Septal Puncture During Mitral Valvuloplasty(ELSEVIER SCIENCE INC, 2013) Akkaya, Emre; Vuruskan, Ertan; Zorlu, Ali; Sincer, Isa; Kucukosmanoglu, Mehmet; Ardic, Idris; Yilmaz, Mehmet Birhan…Öğe Aortic intracardiac echocardiography-guided septal puncture during mitral valvuloplasty(OXFORD UNIV PRESS, 2014) Akkaya, Emre; Vuruskan, Ertan; Zorlu, Ali; Sincer, Isa; Kucukosmanoglu, Mehmet; Ardic, Idris; Yilmaz, Mehmet BirhanTransoesophageal echocardiography (TEE) and venous intracardiac echocardiography (ICE) are traditionally used to visualize the interatrial septum (IAS) and the tenting effect of the fossa ovalis in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV). The aim of the present study was to assess the comparative efficacy and safety of arterial (intra-aortic) ICE and venous ICE, compared with TEE (traditional approach), in the patients undergoing PBMV. TEE, aortic ICE, and venous ICE were consecutively performed in 50 patients (40 9 years, 86 female). The images of intracardiac structures were obtained from both aortic and right atrial loci. The IAS was visualized using TEE, aortic ICE, and venous ICE. The mean mitral valve area was 1.14 0.2 cm(2), and the mean left atrial volume index was 57.5 12 mL/m(2). The mean size of the visualized septal length was 48 5 mm by TEE, 51 5 mm by aortic ICE, and 33 6 mm by venous ICE. The BlandAltman test indicated that the 95 limits of agreement for the measurement of septal diameter ranged from 11.0 to 5.9 mm (mean 2.5 mm) between TEE and aortic ICE, 2.8 to 33.5 mm (mean 15.3 mm) between TEE and venous ICE, and 36.6 to 0.8 mm (mean 17.9 mm) between venous and aortic ICE. Standard venous ICE generally tended to yield smaller values compared with TEE and aortic ICE for the measurement of septal length. Furthermore, the view of fossa ovalis and tenting effect was optimal in 11 patients on venous ICE; however, the fossa ovalis and tip of the needle were well visualized in all patients on aortic ICE (P 0.001). There were no major complications with the use of aortic ICE. Aortic ICE is a superior alternative to venous ICE and facilitates trans-septal puncture in patients with mitral stenosis.Öğe Association Between ApoE4 Allele and Deep Venous Thrombosis: A Pilot Study(SAGE PUBLICATIONS INC, 2011) Katrancioglu, Nurkay; Manduz, Sinasi; Ozen, Filiz; Yilmaz, Mehmet Birhan; Atahan, Erhan; Ozdemir, Ozturk; Berkan, OcalMaterials and Methods: We aimed to search the relative frequencies ApoE alleles among patients with DVT and healthy participants. We enrolled 59 consecutive patients with DVT and 59 age- and sex-matched healthy controls. Results: In the DVT group, E3/E4 gene polymorphism was detected in 20 patients (33.9%), in the control group E3/E4 polymorphism was detected in six patients (10.2%; P = .002). In the multivariable regression analysis, E3/E4 was independently associated with 1.31-fold increased risk of DVT (odds ratio [OR] 1.31; 95% confidence interval [CI], 1.30-10.48). Conclusion: It seems there is a relationship between ApoE3/E4 gene polymorphism and DVT in the Turkish population. However, this pilot study should be supported with large-scale studies.Öğe Association between metabolic syndrome and late saphenous vein graft disease(Turkish Soc Cardiology, 2006) Yilmaz, Mehmet Birhan; Guray, Umit; Guray, Yesim; Biyikoglu, Senay Funda; Kisacik, Halil L.; Korkmaz, SuleObjectives: Saphenous vein grafts have been widely used in coronary bypass operations for many years. We investigated the association between metabolic syndrome (MS) and late saphenous graft disease. Study design: The study included 193 patients (16 females, 177 males; mean age 62 +/- 8 years; range 39 to 86 years) in whom at least one saphenous vein graft had been used during coronary bypass operation of at least 10-year history. All the patients underwent coronary angiography for anginal complaints or preoperative assessment. Patients were classified into two groups. Group 1 was comprised of 72 patients with patent saphenous graft, whereas group 2 included 121 patients without patency or with associated lesions. The two groups were compared in terms of their medications, anthropometric measurements, blood biochemistry, and the presence of hypertension, diabetes mellitus, smoking, and MS. Results: Metabolic syndrome was less frequent in group 1 than in group 2 (22% vs. 45.6%, p=0.003). Metabolic syndrome score, derived from the sum of MS components, was higher in group 2 than in group 1 (2.3 +/- 1 vs. 1.8 +/- 1.2, p=0.003). In a multivariate logistic regression analysis, duration from bypass to coronary angiography (beta=0.812, p=0.017) and MS score (beta=0.590, p=0.005) were found to be independent factors related to saphenous graft patency. Conclusion: Metabolic syndrome score seems to be associated with late saphenous vein graft disease. Early measures for MS may affect the prognosis of patients undergoing coronary bypass operations.Öğe Association of P wave duration and dispersion with the risk for atrial fibrillation: Practical considerations in the setting of coronary artery disease(ELSEVIER IRELAND LTD, 2010) Turgut, Okan; Tandogan, Izzet; Yilmaz, Mehmet Birhan; Yalta, Kenan; Aydin, Osman…Öğe Association of pro-inflammatory cytokines and T-cell activation marker with CA-125 levels in obese patients with heart failure: Implications for complex immunoinflammatory pathophysiology(INT SCIENTIFIC LITERATURE, INC, 2011) Beton, Osman; Yilmaz, Mehmet Birhan; Turgut, Okan; Tandogan, Izzet…Öğe Association of right heart with CA-125 levels in patients with heart failure(ELSEVIER IRELAND LTD, 2010) Refiker, Meltem; Yilmaz, Mehmet Birhan…Öğe Association of soluble ST2 Level with 6-month Mortality and/or Recurrent Cardiovascular-Related Hospitalization in Pulmonary Embolism(Arquivos Brasileiros Cardiologia, 2024) Gunes, Hakan; Gunes, Handan; Dagli, Musa; Kirisci, Mehmet; Ozbek, Meryem; Atilla, Nurhan; Yilmaz, Mehmet BirhanBackground: The association of soluble suppression of tumorigenesis-2 (sST2) levels with prognosis in pulmonary embolism (PE) is unknown. Objective: This study aimed to investigate the relationship between sST2 levels in patients with acute PE and 6 -month mortality and recurrent hospitalizations. Methods: This prospective study included 100 patients with acute PE. Patients were classified into two groups according to 6 -month mortality and the presence of recurrent Cardiovascular -Related hospitalizations. Two groups were compared. A p -value of 0.05 was considered statistically significant. Results: Soluble ST2 levels were significantly higher in the group with mortality and recurrent hospitalizations. (138.6 ng/mL (56.7-236.8) vs. 38 ng/mL (26.3-75.4); p<0.001) The best cut-off threshold for sST2 levels in the prediction of a composite outcome of 6 -month mortality and/or recurrent Cardiovascular -Related hospitalization was found to be >89.9 with a specificity of 90.6% and a sensitivity of 65.2%, according to the receiver operating characteristic curve (area under the curve = 0.798; 95% CI, 0.705-0.891; p <0.0001). After adjusting for confounding factors that were either statistically significant in the univariate analysis or for the variables correlated with the sST2 levels, sST2 level (OR = 1.019, 95% CI: 1.009-1.028, p 0.001) and C -reactive protein (CRP ) (OR = 1.010, 95% CI: 1.001-1.021, p = 0.046) continued to be significant predictors of 6 -month mortality and/or recurrent Cardiovascular -Related hospitalization in the multiple logistic regression model via backward stepwise method. Conclusion: Soluble ST2 level seems to be a biomarker to predict 6 -month mortality and/or recurrent CardiovascularRelated hospitalization in patients with acute PE.Öğe Associations between common 3435 C > T variants of the multi-drug resistance [MDR-1 (ABCB1)] gene and abdominal aortic aneurysm: a pilot study(EKIN TIBBI YAYINCILIK LTD STI-EKIN MEDICAL PUBL, 2011) Manduz, Sinasi; Katrancioglu, Nurkay; Karahan, Oguz; Yilmaz, Mehmet Birhan; Ozdemir, Ozturk; Berkan, OcalBackground: The aim of the study was to reveal the effect of the C3435T MDR-1 gene polymorphism in AAA, which has been postulated to play a role in the inflammatory process and protection against oxidative stress. Methods: In this study, we scanned the MDR gene polymorphisms in peripheral blood samples of the 58 patients (41 males, 17 females; mean age 62.9 +/- 6.6 years) whom were operated on after the diagnosis of AAA, and of the 58 healthy individuals (38 males, 20 females; mean age 58.8 +/- 11.6 years) have normally measured aorta diameters on abdominal computed tomography scan. Results: We found that MDR-1 C3435T gene CT variant (x(2)=5.80; p=0.016) and MDR-1 C3435T gene TT variant (x(2)=11.47; p=0.001) polymorphisms was statistically significant in AAA cases (p<0.05). The demographic findings were similar in each group. Conclusion: These obtained preliminary results suggest that the T allele polymorphism of the MDR-1 gene is associated with AAA. We belive that such molecular studies will blaze a trail for future studies on the understanding of AAA etiology.Öğe Asymptomatic total anomalous pulmonary venous connection with double drainage in a young adult: A case report(FORUM MULTIMEDIA PUBLISHING, LLC, 2007) Yalta, Kenan; Turgut, Okan Onur; Yilmaz, Ahmet; Yilmaz, Mehmet Birhan; Manduz, Sinasi; Karadas, Filiz; Dogan, Kasim; Tandogan, IzzetTotal anomalous pulmonary venous connection is an uncommon congenital anomaly in which all pulmonary venous return drains to the right atrium or one of its tributaries. Survival beyond infancy without surgical palliation is unlikely, so this anomaly is not encountered in the adult population with congenital heart disease. The patient presented here was 22 years old on admission and had no total anomalous pulmonary venous connection-associated symptoms. He underwent transthoracic echocardiographic examination for atypical chest pain. Transthoracic echocardiography along with cardiac catheterization favored the presence of a total anomalous pulmonary venous connection. Surgical correction of pulmonary venous confluence ( draining to both the coronary sinus and right atrium) was performed successfully. This is a rare case of total anomalous pulmonary venous connection with no reported symptoms in contrast to the majority of patients who are symptomatic during the first year of life.Öğe Atrial fibrillation and D dimer levels for patients with acute decompensated heart failure(ELSEVIER IRELAND LTD, 2016) Kaya, Hakki; Beton, Osman; Yilmaz, Mehmet Birhan…Öğe Atypical antipsychotic use is an independent predictor for the increased mean platelet volume in patients with schizophrenia: A preliminary study(ISFAHAN UNIV MED SCIENCES, 2013) Semiz, Murat; Yucel, Hasan; Kavakci, Onder; Yildirim, Osman; Zorlu, Ali; Yilmaz, Mehmet Birhan; Kucukdurmaz, Zekeriya; Canan, FatihBackground: Cardiovascular diseases, cardiovascular risk factors, and mortality due to these situations are more frequently encountered in schizophrenic patients when compared with the general population. The mean platelet volume (MPV) is a surrogate biomarker of the platelet activity and an useful prognostic test in cardiometabolic diseases. The aim of this study was to investigate what influenced MPV levels in patients with schizophrenia. Materials and Methods: We evaluated hospital records of 60 hospitalized schizophrenia patients. Thirty age-and sex-matched healthy control subjects were also included as a control group. Results: MPV levels were significantly higher in patients who were on atypical antipsychotic drugs than in patients who were not using any drug (9.2 +/- 0.8 vs. 8.6 +/- 0.8 fL, P = 0.016) and also higher than control group (9.2 +/- 0.8 vs. 8.1 +/- 0.9 fL, P < 0.001). Furthermore, patients who were not using antipsychotics had higher MPV than control group (8.6 +/- 0.8 vs. 8.1 +/- 0.9 fL, P = 0.036). Atypical antipsychotic use [Odds ratio (OR) = 6.152, 95% confidence interval (CI,) P = 0.003)] and platelet distribution width (OR = 0.989, 95% CI, P = 0.032) were associated with high MPV levels in univariate analysis. In multivariate logistic regression model, only atypical antipsychotics use (OR = 6.152, 95% CI, P = 0.003) was found to be independent predictor of high MPV levels after adjustment of other potential confounders (age, gender, presence of hypertension, diabetes mellitus, hyperlipidemia, and smoking). Conclusion: MPV seems to be influenced not only by schizophrenia itself but also by atypical antipsychotic drugs. It might be concluded that schizophrenic patients are under increased risk for cardiometabolic diseases and risk factors and this risk is higher in patients on atypical antipsychotic treatment.Öğe The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR(TURKISH SOC CARDIOLOGY, 2016) Celik, Ahmet; Izci, Servet; Kobat, Mehmet Ali; Ates, Ahmet Hakan; Cakmak, Abdulkadir; Cakilli, Yasin; Yilmaz, Mehmet Birhan; Zoghi, MehdiObjective: The awareness, time in therapeutic range (TTR), and safety of warfarin therapy were investigated in the adult Turkish population. Methods: This multicenter prospective study includes 4987 patients using warfarin and involved regular international normalized ratio (INR) monitoring between January 1, 2014 and December 31, 2014. TTR was calculated according to F.R. Roosendaal's algorithm. Awareness was evaluated based on the patients' knowledge of warfarin's affect and food-drug interactions. esults: The mean TTR of patients was 49.52 +/- 22.93%. The patients with hypertension (55.3%), coronary artery disease (23.2%), congestive heart failure (24.5%), or smoking habit (20.8%) had significantly lower TTR levels than the others. Of the total number of patients, 42.6% had a mechanical valve, 38.4% had non-valvular atrial fibrillation (AF), and 19% had other indications for warfarin. Patients with other indications had lower TTR levels than those with mechanical valve and non-valvular AF (p=0.018). Warfarin awareness decreased in higher age groups. The knowledge of warfarin's food-drug interactions was 55%. People with higher warfarin awareness had higher TTR levels. Patients with <= 8 INR monitoring/year had lower TTR levels (46.4 +/- 25.3 vs. 51.1 +/- 21.3, respectively, p<0.001) and lower awareness (44.6% vs. 60.6%, p<0.001) than patients with >= 8 INR monitoring/year. In this study, 20.1% of the patients had a bleeding event (major bleeding 15.8%, minor bleeding 84.2%) within a year. Conclusion: Both the mean TTR ratios and awareness of the Turkish population on warfarin therapy were found to be low. It was thought that low TTR levels of the Turkish population may be caused by the low awareness of warfarin, warfarin's food-drug interactions, and high rates of concomitant diseases.
