Gene polymorphism as a cause of hemorrhagic complications in patients with non-valvular atrial fibrillation treated...

Area of Science:

• Pharmacogenomics
• Cardiology
• Drug Metabolism

Background:

• Atrial fibrillation (AF) is a common arrhythmia linked to high stroke risk.
• Direct oral anticoagulants (DOACs) like dabigatran, rivaroxaban, apixaban, and edoxaban are crucial for stroke prevention in AF.
• Individual responses to DOACs can vary, necessitating research into genetic influences.

Purpose of the Study:

• To review and analyze scientific literature on gene polymorphisms affecting DOAC metabolism and efficacy.
• To explore the impact of pharmacogenetics on DOAC pharmacokinetics, pharmacodynamics, and clinical outcomes.
• To identify potential genetic markers for optimizing DOAC therapy and minimizing hemorrhagic complications.

Main Methods:

• Systematic literature search of PubMed, Cochrane, Google Scholar, and CyberLeninka databases.
• Inclusion of full-text articles, meta-analyses, observational studies, and studies on single-nucleotide polymorphisms (SNPs) and DOACs.
• Focus on studies published in English and Russian over the last 10 years, involving patients aged 18-75.

Main Results:

• Identified various gene polymorphisms influencing DOAC metabolism and response.
• Pharmacogenomic data indicates differences in how genetic variations affect DOACs.
• Current data highlights the potential for personalized DOAC therapy but is limited by the lack of large-scale studies.

Conclusions:

• Gene polymorphisms play a significant role in DOAC efficacy and safety.
• Personalized anticoagulant therapy based on patient genotyping may reduce hemorrhagic risks.
• Large-scale population studies are essential to establish genotype-guided DOAC dosing strategies.