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Updated: Jul 18, 2026

A Method to Study the C924T Polymorphism of the Thromboxane A2 Receptor Gene
Published on: April 1, 2019
A coding VKORC1 Asp36Tyr polymorphism predisposes to warfarin resistance.
Ronen Loebstein1, Ilana Dvoskin, Hillel Halkin
1Institute of Clinical Pharmacology and Toxicology, Sheba Medical Center, Tel Hashomer, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Israel.
A newly identified VKORC1 Asp36Tyr genetic variant is a significant marker for high warfarin dose requirements. This finding helps characterize genetic factors influencing warfarin resistance and optimize dosing strategies.
Area of Science:
- Pharmacogenomics
- Clinical Pharmacology
- Genetics
Background:
- Genetic variations in CYP2C9 and VKORC1 are known to influence warfarin dosing, typically associated with lower dose requirements.
- Markers for high warfarin dose requirements (warfarin resistance) are less understood, limiting personalized treatment strategies.
Purpose of the Study:
- To identify novel genetic markers associated with warfarin resistance.
- To characterize the VKORC1 Asp36Tyr polymorphism and its association with warfarin dose requirements.
Main Methods:
- Analysis of VKORC1 coding sequences and known CYP2C9/VKORC1 polymorphisms in warfarin-resistant, warfarin-sensitive patients, and controls.
- Statistical analysis to determine the association between the VKORC1 Asp36Tyr variant and warfarin dose requirements.
Main Results:
- The VKORC1 Asp36Tyr polymorphism was identified in 7 of 15 resistant patients but none of the sensitive patients (P = .026).
- Carriers of Asp36Tyr in controls required significantly higher warfarin doses (80.9 mg/wk) compared to non-carriers (42.7 mg/wk) (P = .002).
- Asp36Tyr was significantly associated with doses >70 mg/wk (OR, 13.0) and also with doses between 20-70 mg/wk, alongside other known variants.
Conclusions:
- VKORC1 Asp36Tyr is a novel genetic marker associated with high warfarin dose requirements.
- This variant, particularly prevalent in specific ethnic groups, aids in predicting warfarin resistance and optimizing patient dosing.
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