Polymorphism of the CYP2C9 and VKORC1 genes in patients on the public health system of a municipality in Southern Brazil

Genetic factors can be responsible for part of the populational and interindividual differences observed in warfarin users. To identify occurrence of polymorphisms of the CYP2C9 and VKORC1 genes in patients taking warfarin and relate these profiles to their medication dosages and the Time in Therape...

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Published inJornal vascular brasileiro Vol. 20; p. e20200214
Main Authors Colet, Christiane, Botton, Mariana Rodrigues, Schwambach, Karin Hepp, Amador, Tânia Alves, Heineck, Isabela
Format Journal Article
LanguageEnglish
Published Brazil Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 01.01.2021
Subjects
adverse effects
CARDIAC & CARDIOVASCULAR SYSTEMS
genetic polymorphism
Original
PERIPHERAL VASCULAR DISEASE
SURGERY
warfarin
adverse effects
genetic polymorphism
warfarin
efeitos adversos
varfarina
polimorfismo genético
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Summary:Genetic factors can be responsible for part of the populational and interindividual differences observed in warfarin users. To identify occurrence of polymorphisms of the CYP2C9 and VKORC1 genes in patients taking warfarin and relate these profiles to their medication dosages and the Time in Therapeutic Range (TTR). Monthly interviews were conducted for data collection. Data were collected on demographic characteristics and medications in use, especially warfarin, including reason for prescription and weekly dose. TTR was calculated as the percentage of days with international normalized ratio (INR) between 2 and 3. The CYP2C9 and VKORC1 genes were analyzed at a Human Genetics Laboratory. 49 patients (74.2%) had polymorphisms of the CYP2C9 and/or VKORC1 genes; the remaining 17 (25.8%) did not have these polymorphisms. The average weekly dose of warfarin was lower among those who had a polymorphism for any of the genes compared to those who did not, with a significant difference (p = 0.035). The mean TTR was also lower among patients with polymorphism. However, the difference between the two groups was not significant for this variable (p = 0.438). An association was observed between the polymorphisms and the warfarin doses taken by the patients. However, there was no association with adverse events or the time spent within the therapeutic range in this sample.
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Conflicts of interest: No conflicts of interest declared concerning the publication of this article.
Author information CC - PhD in Pharmaceutical Sciences; Adjunct Professor, Department of Life Sciences, Universidade Regional do Noroeste do Estado do Rio Grande do Sul (UNIJUÍ). MRB - PhD in Genentics and Molecular Biology; Researcher, Hospital de Clínicas de Porto Alegre. KHS - PhD in Hepatology; Researcher, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA). TAA - PhD in Biological Sciences-Biochemistry; Adjunct Professor, Faculty of Pharmacy, Universidade Federal do Rio Grande do Sul (UFRGS). IH - PhD in Pharmaceutical Sciences; Professor, Faculty of Pharmacy and Pharmaceutical Sciences Post Graduation Program, Universidade Federal do Rio Grande do Sul (UFRGS).
Author contributions Conception and design: CC, TAA, IH Analysis and interpretation: CC, MRB, IH Data collect: CC, MRB Writing the article: CC, MRB, KHS, TAA, IH Critical revision of the article: CC, MRB, KHS, TAA, IH Final approval of the article*: CC, MRB, KHS, TAA, IH Statistical analysis: CC Overall responsibility: CC *All authors have read and approved of the final version of the article submitted to J Vasc Bras.
ISSN:1677-5449
1677-7301
1677-7301
DOI:10.1590/1677-5449.200214