Association of polymorphisms of cytochrome P450 2C9 exon 4 and -65G>C with warfarin sensitivity

OBJECTIVE: To investigate the association of the polymorphisms of cytochrome P450 2C9 (CYP2C9) exon 4 608T/G, 561A/C, 537A/C and 527A/C, and -65G/C with warfarin sensitivity.

METHODS: A total of 102 patients under warfarin anticoagulant therapy were selected. During follow-up, warfarin dosage and associated Prothrombin Time-International Normalized Ratio (P-INR) values were recorded. Simultaneous monitoring of incidence of bleeding and thrombosis adverse effect was recommended. Genetic polymorphisms of the above mentioned loci were identified by polymerase chain reaction and DNA sequencing.

RESULTS: The average age of the 102 patients was (62.1+/-10.5) years. The body mass index (BMI) was (24.7+/-3.8) kg/m2. Mean daily warfarin requirement was from 1.250 to 5.077 mg/day when therapeutic PT-INR (1.5-2.5) was maintained. DNA sequencing showed no polymorphisms of 608T/G, 561A/C, 537A/C, 527A/C in CYP2C9 exon 4. Warfarin daily dosage in CYP2C9 exon 4 -65C carriers was 3.106+/-0.619 mg/d, while it was (2.555+/-0.708) mg/d in individuals with wild-type -65G (P=0.020). Receiver operating characteristic (ROC) analysis showed that warfarin daily dosage of more than 2.5 mg/d can be used to predict the CYP2C9 exon 4 -65GC genotype (AUC: 0.770, P=0.005, 95%CI:0.626-0.915). Logistic regression indicated that BMI was an independent factor of bleeding during anti-coagulation therapy (OR=0.794, 95%CI: 0.651-0.970, P=0.024).

CONCLUSION: The Chinese population are, generally, warfarin-sensitive. Exon 4 of the CYP2C9 gene is highly conserved in this population. The warfarin maintenance dosage in CYP2C9 exon 4 -65CG carriers was significantly higher than those with wild-type -65GG. The clinical significance needs further investigation with more large-scale, multi-center trials.

Medienart:

E-Artikel

Erscheinungsjahr:

2010

Erschienen:

2010

Enthalten in:

Zur Gesamtaufnahme - volume:27

Enthalten in:

Zhonghua yi xue yi chuan xue za zhi = Zhonghua yixue yichuanxue zazhi = Chinese journal of medical genetics - 27(2010), 4 vom: 27. Aug., Seite 428-32

Sprache:

Chinesisch

Beteiligte Personen:

Wang, Zan-xin [VerfasserIn]
Huang, Lei [VerfasserIn]
Cai, Heng [VerfasserIn]
Men, Jian-long [VerfasserIn]
Wei, Min-xin [VerfasserIn]

Links:

Volltext

Themen:

5Q7ZVV76EI
Anticoagulants
Aryl Hydrocarbon Hydroxylases
CYP2C9 protein, human
Cytochrome P-450 CYP2C9
EC 1.14.13.-
EC 1.14.14.1
English Abstract
Journal Article
Warfarin

Anmerkungen:

Date Completed 10.12.2010

Date Revised 20.11.2014

published: Print

Citation Status MEDLINE

doi:

10.3760/cma.j.issn.1003-9406.2010.04.015

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM200009230