Influence of CYP2C9 and VKORC1 polymorphisms on the time required to reach the therapeutic INR
Journal Title: Human & Veterinary Medicine - International Journal of the Bioflux Society - Year 2012, Vol 4, Issue 3
Abstract
Oral anticoagulation (OAC) is characterized by a narrow therapeutic index and a high interindividual variability, both in terms of pharmacokinetics and pharmacodynamics. We have considered useful and interesting to research the factors that could play a role in determining the time required for Acenocoumarol to achieve its optimal therapeutic response. Material and method: The present research is a cross analytic observational study. We included 105 patients treated with an initial dose of 4 mg Acenocoumarol, for one or more of the following clinical situations: 1. Deep venous thrombosis of the lower limbs (DVT) ± pulmonary thromboembolism (PTE); 2. Permanent atrial fibrillation (AF); 3. Prosthetic heart valve. Results and conclusions: The presence of CYP2C9*2 and CYP2C9*3 alleles did not affect the time required to reach a therapeutic INR. The c.-1639G>A polymorphism of the VKORC1 gene significantly and statistically influenced the time to reach the target INR. The existence of a supratherapeutic INR during the initial phase of anticoagulant treatment causes a 35% lower probability of reaching a therapeutic INR on the fifth day of anticoagulant treatment.
Authors and Affiliations
Florentina Militaru, Sorin Crişan, Ştefan Vesa, Adrian Trifa, Valentin Militaru, Anca Buzoianu
Keywords
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