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

Aims: the study aims to evaluate the impact of genetic,demographic and clinical data on various measures of outcome of anticoagulation quality in patients. patients and methods: the study consisted of 310 patients receiving long-term oral anticoagulation therapy in our hospital. apart from demographic and clinical variables,21 snps (in 7 genes) were analyzed and compared with the outcomes of anticoagulation therapy. various outcomes that were measured are; supra therapeutic inrs (inr >3,>6),anticoagulation stabilization,time taken to stabilize and proportion of inrs within (23),above (>3) and below (<2) therapeutic range. results: supra therapeutic inrs were influenced by cyp2c9*2,*3,cyp4f2 rs2108622,vkorc1-1639g>a,1173c>t,rs55894764 along with concomitant drugs,smoking,body weight and height. persistently fluctuating inrs/absolute instability correlated with vkorc1-1639g>a,gender,height and body mass index. the time taken to stabilize was associated with cyp4f2 rs2108622,cyp2c9*14,smoking,clinical indication and concomitant drugs. the overall distribution of inr was influenced by variants in cyp4f2 rs2108622,cyp2c9*3,rs9332230,vkorc1 1173c>t,-1639g>a,rs55894764,abcb1 rs2032582,rs1128503,rs1045642 and f5 rs6025,age,smoking and concomitant drugs. conclusions: knowledge of factors influencing the quality of long term anticoagulation can help clinicians to customize therapy either by dose variation,therapy with alternate choice of drug,concurrent heparin therapy and/or frequent inr monitoring. © 2014 institute of pharmacology,polish academy of sciences. published by elsevier urban & partner sp. z o.o. all rights reserved.