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CYP2C9, VKORC1, CYP4F2, ABCB1 and F5 variants: influence on quality of long-term anticoagulation

Risha Nahar1, Renu Saxena2, Roumi Deb3

  • 1Krishna Institute of Medical Sciences (KIMS), KIMS Foundation and Research Center (KFRC), Hyderabad, India; Center of Medical Genetics, Sir Ganga Ram Hospital,, New Delhi; Amity Institute of Biotechnology, Amity University, Noida, India.

Pharmacological Reports : PR
|June 10, 2014
PubMed

Insights

Genetic and clinical factors significantly impact oral anticoagulation therapy outcomes. Understanding these influences allows for personalized treatment strategies to improve anticoagulation quality.

Area of Science:

  • Pharmacogenomics
  • Clinical Pharmacology
  • Internal Medicine

Background:

  • Oral anticoagulation therapy (OAT) is crucial for preventing thromboembolic events.
  • Optimizing OAT requires careful management of anticoagulation quality, often assessed by INR.
  • Individual patient factors, including genetics, can influence OAT response and outcomes.

Purpose of the Study:

  • To investigate the impact of genetic variations, demographic data, and clinical factors on anticoagulation quality measures.
  • To identify specific genetic markers and clinical parameters associated with INR variability and stabilization.

Main Methods:

  • A cohort of 310 patients on long-term OAT was studied.
  • Genotyping of 21 single nucleotide polymorphisms (SNPs) across 7 genes was performed.
  • Demographic, clinical variables, and INR outcomes (supra-therapeutic levels, stabilization time, INR range distribution) were analyzed.

Main Results:

  • Supra-therapeutic INRs were linked to CYP2C9, CYP4F2, VKORC1 variants, and lifestyle factors (smoking, BMI).
  • INR fluctuations correlated with VKORC1 variants, gender, height, and BMI.
  • Time to INR stabilization was associated with CYP4F2, CYP2C9 variants, smoking, and clinical indication.

Conclusions:

  • Genetic polymorphisms in CYP2C9, CYP4F2, VKORC1, ABCB1, and F5, along with clinical and lifestyle factors, significantly influence OAT quality.
  • Personalized OAT strategies, including dose adjustments or frequent monitoring, can be informed by these influencing factors.
  • This knowledge aids clinicians in optimizing anticoagulation therapy for improved patient safety and efficacy.
Abstract

Keywords:
AcenocoumarolAnticoagulationGeneticIndiaWarfarin

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