Accuracy of an internationally validated genetic-guided warfarin dosing algorithm compared to a clinical algorithm in an Arab population
<h3>Purpose</h3><p dir="ltr">To identify the impact of <i>CYP2C9*2, *3, VKORC1−1639 G>A </i>and <i>CYP4F2*3</i> on warfarin dose in an Arab population. To compare the accuracy of a clinical warfarin dosing (CWD) versus genetic warfarin dosing al...
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , , , , |
| منشور في: |
2024
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| الموضوعات: | |
| الوسوم: |
إضافة وسم
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| الملخص: | <h3>Purpose</h3><p dir="ltr">To identify the impact of <i>CYP2C9*2, *3, VKORC1−1639 G>A </i>and <i>CYP4F2*3</i> on warfarin dose in an Arab population. To compare the accuracy of a clinical warfarin dosing (CWD) versus genetic warfarin dosing algorithms (GWD) during warfarin initiation. </p><h3>Methods</h3><p dir="ltr">A cohort of Arab patients newly starting on warfarin had their dose calculated using CWD published in www.warfarindosing.org and were followed for 1 month. Each patient provided a saliva sample. DNA was extracted, purified and genotyped for <i>VKORC−1639 G>A, CYP2C9*2, CYP2C9*3 </i>and<i> CYP4F2*3</i>. After reaching warfarin maintenance dose, the dose was recalculated using the GWD and median absolute error (MAE) and the percentage of warfarin doses within 20% of the actual dose were calculated and compared for the two algorithms. </p><h3>Results</h3><p dir="ltr">The study enrolled 130 patients from 12 Arabian countries. Compared to those with wild type, carriers of reduced function alleles in <i>CYP2C9</i> required significantly lower median (IQR) warfarin weekly dose [24.5 (15.3) vs. 35 (29.8) mg/week, p=0.006]. With regards to VKORC, patients with AA genotype had a significantly lower median (IQR) weekly warfarin dose compared to AG and GG [21(10.5) vs 29.4 (21), p<0.001 for AA vs AG, p<0.001 for AA vs GG]. The MAE (IQR) for the weekly dose of the GWD was significantly lower compared to CWD [8.1 (10.5) vs 12.4 (12.6) (p<0.001)]. </p><h3>Conclusion</h3><p dir="ltr"><i>CYP2C9 </i>and<i> VKORC1</i> variants are important determinants of warfarin dose in the Arab population. The use of the genetic and clinical factors led to better warfarin dose estimation when compared to clinical factors alone.</p><h2>Other Information</h2><p dir="ltr">Published in: Current Problems in Cardiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.cpcardiol.2024.102865" target="_blank">https://dx.doi.org/10.1016/j.cpcardiol.2024.102865</a></p> |
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