SESSION TITLE: Pulmonary Hypertension SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Pulmonary arterial hypertension (PAH) is a life threatening and potentially fatal disorder. The 2013 Nice Edition of PH Classification recognized “Drug & toxin induced PH” as a separate sub-class (1.3) in World Health Organization (WHO) Group I PAH, and highlighted Methamphetamine (ME) as a “likely” cause of PAH. A previous study (Chin et al, Chest 2006) demonstrated Methamphetamine abuse (MEA) in 28.9% of patients with IPAH. Methamphetamine associated PAH (MAPAH) is a growing problem and increasingly recognized in clinical practice and its true incidence, prevalence and characteristics remain unknown. We present phenotypic, social and compliance characteristics of our cohort of MAPAH in this sub-study. METHODS: Single center, retrospective study. We identified patients (n=56) since 2008 from our research database (PHASE) with history of MEA and right heart catheterization (RHC) proven WHO Group-I PAH. RESULTS: Of 56 MAPAH patients - Mean age was 46.5 (SD 8.3), M:F 17:39, 95% of the cohort was White. The breakdown of WHO functional class upon diagnosis was I-0, II-7(12.5%), III-35(62.5%), IV-14(25%). 65.5% had coexistent tobacco use, 28.6% had coexistent alcohol use, 25.0% had marijuana use, 28.6% had coexistent cocaine use. Route of administration was inhalation in 90.5%, intravenous in 8.9% and skin-popping in 1.8%. In 36 of 56 (64.28%) MEA was the only risk factor PAH. Others in the group had additional risk factors such as CHD (11), CTD (7) & HIV (2). 49 of 56 had state regulated Medicaid or no insurance. Only 7 had a private payer source. There was a substantial increase in healthcare burden following the diagnosis of PAH compared to prior to diagnosis as evidenced by a 10-fold increase in ER visits within 12 months post-diagnosis of PAH and doubling of hospitalizations. Subjective assessments of social framework system revealed of the 56 patients, 34 (60.7%) have family support. 11 live alone (19.6%) and 33 (58.9%) live with family or friends. 38 (67.9%) have a stable home and 21 (37.5%) attend clinic with their family. 8 (14.3%) attend PH support group with family. 11 (19.6%) are self-motivated and 24 (42.9%) have problems with transportation. 20 (35.7%) have lack of insight. Only 19/56 were considered compliant. The remaining 37/56 were non or poorly compliant (Compliance was defined as: 1. Complete abstinence from ME based upon results of follow-up urine screens for ME 2. Attendance of > 50% of out patient clinic appointments). There were a total of 12 deaths in this group. CONCLUSIONS: MAPAH demonstrated the following characteristics 1. Female predominant but with higher proportion of males 2. Majority affected were Whites 3. More than a ¼ had concomitant use of other drugs 4. In a clear majority of the cohort (65%), ME was the single risk factor for PAH 5. Substantial increases in healthcare utilization following the diagnosis of PAH 6. Compliance issues were observed in majority (66%) which may explain poor outcomes, higher mortality and increased healthcare utilization CLINICAL IMPLICATIONS: This study elaborates phenotypic and social characteristics of this sub-class of patients with Methamphetamine associated PAH and also identifies unique challenges that may affect their outcomes such as compliance issues and healthcare utilization. DISCLOSURE: The following authors have nothing to disclose: Paymon Ebrahimzadeh, Kirat Gill, Matthew Beutner, Jonathan Tse, Shilpi Gupta, Aysha Khan, Vijay Balasubramanian No Product/Research Disclosure Information