Title
Pharmacogenetic Impact of VKORC1 and CYP2C9 allelic variants on warfarin dose requirements in a hispanic population isolate
Date Issued
01 February 2010
Resource Type
Journal
Author(s)
Palacio L.
Falla D.
Tobon I.
Lewis J.E.
Martinez A.F.
Arcos-Burgos M.
Camargo M.
Hospital Universitario San Vicente de Paú L
Abstract
Warfarin is the most prescribed oral anticoagulant worldwide. Because of the complexity of warfarin therapy, we attempted to dissect genetic from bioenvironmental factors influencing warfarin dose responses in individuals of a genetic isolate of Hispanic ancestry. A total of 191 patients with standard values of international normalized ratio were recruited. Three groups with a significantly different warfarin dose response were identified, that is, sensitive (2.28 ± 0.50 mg/d), intermediate (4.2 ± 0.76 mg/d), and resistant (7.40 ± 1.54 mg/d; Tukey test, P <001). Age had a significant inverse correlation with warfarin dose (P <001; effective dose diminished 0.56 mg/d/decade). Required doses were higher for individuals with CYP2C9 variants containing the allele *1 compared to those individuals with variants composed of other alleles (P =.006). Similarly, individuals with VKORC1-1639GG and VKORC1-1639GA genotypes also required higher doses compared to the AA genotype (P <001). Evaluation of potential gene-gene interactions between CYP2C9 and VKORC1 polymorphisms showed significant differences in dosing for CYP2C9 genotypes within the VKORC1-1639G/A subgroup (P =.013). A stepwise multivariate linear regression analysis showed that 38.2% of the warfarin dose response variance was accounted for by a model involving age (20.9%), VKORC1-1639G/A (11.3%), and CYP2C9*1, *2, and *3 variants (7.1%). These results corroborate previous findings on warfarin pharmacogenetics and define a contrastable gene-bioenvironment interaction model suited to be used in Hispanic populations.
Start page
83
End page
90
Volume
16
Issue
1
Language
English
OCDE Knowledge area
Farmacología, Farmacia
Subjects
Scopus EID
2-s2.0-76049103379
PubMed ID
Source
Clinical and Applied Thrombosis/Hemostasis
Resource of which it is part
Clinical and Applied Thrombosis/Hemostasis
ISSN of the container
10760296
Sources of information:
Directorio de Producción Científica
Scopus