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POTENTIAL OF PHARMACOGENETICS IN THE CORRECTION OF ANTICOAGULANT THERAPY AMONG PATIENT WITH PROSTHETIC HEART VALVES

https://doi.org/10.15829/1728-8800-2013-3-24-28

Abstract

Aim. To compare the effectiveness of various pharmacogenetics algorithms of warfarin dosage and to identify the strengths and limitations of standard genetic tests for the warfarin dose correction during the late postoperative period among 134 warfarin-treated patients with prosthetic heart valves.

Material and methods. All patients underwent genotyping for the CYP2C9 gene polymorphisms (CYP2C9*2 (С430Т) and CYP2C9*3 (А1075C) and for the vitamin K epoxide reductase complex subunit 1 VKORC1 (G-1639A). To compare the empirical and calculated warfarin doses, formulas by Gadge BF et al., Sconce EA et al., Anderson JL et al., and Takahashi H et al. were used.

Results. In 54 (40%) patients with adequate levels of international normalised ratio (INR; 2,0–3,0), empirical warfarin doses were the closest to the doses calculated using the formula by Gadge BF et al. In 49 (37%) patients with 2>INR>3, there was a mismatch between empirical and calculated warfarin doses, while in 31 (23%) patients, the pharmacogenetics algorithm of choice was inadequate.

Conclusion. The algorithm by Gadge BF et al. should be the first option in the process of choosing and/or correcting the dosage of warfarin. Additional pharmacogenetics algorithms require further improvement.

About the Authors

I. Yu. Zhuravleva
ZAO NeoCor, Kemerovo
Russian Federation


T. V. Burkova
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences
Russian Federation
tel.: 8 (3842) 778616, 8 (3842) 644650


N. V. Rutkovskaya
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences
Russian Federation


E. V. Gorbunova
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences
Russian Federation


Yu. N. Odarenko
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences
Russian Federation


Yu. Yu. Savostiyanova
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences
Russian Federation


I. A. Goncharova
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences
Russian Federation


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For citations:


Zhuravleva I.Yu., Burkova T.V., Rutkovskaya N.V., Gorbunova E.V., Odarenko Yu.N., Savostiyanova Yu.Yu., Goncharova I.A. POTENTIAL OF PHARMACOGENETICS IN THE CORRECTION OF ANTICOAGULANT THERAPY AMONG PATIENT WITH PROSTHETIC HEART VALVES. Cardiovascular Therapy and Prevention. 2013;12(3):24-28. (In Russ.) https://doi.org/10.15829/1728-8800-2013-3-24-28

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ISSN 1728-8800 (Print)
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