ArticleBlood cells, molecules & diseases
Influence of CYP2C9 and VKORC1 on warfarin response during initiation of therapy.
Article in Blood cells, molecules & diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 56 citations in OpenAlex.
- Trial
- Genetics informatics trial (GIFT) of warfarin to prevent deep vein thrombosis (DVT): rationale and study design.The pharmacogenomics journal · 2012Trial
- Pharmacogenetic distribution of warfarin and its clinical significance in Korean patients during initial anticoagulation therapy.Journal of thrombosis and thrombolysis · 2011Trial
- Pharmacogenomics and Cardiovascular Disease: Where are We and Where do We go from Here?Arquivos brasileiros de cardiologia · 2020Article
- Article
- Impact of genetic and clinical factors on warfarin therapy in patients early after heart valve replacement surgery.European journal of clinical pharmacology · 2019Observational
- Perioperative management of patients with atrial fibrillation receiving anticoagulant therapy.Journal of anesthesia · 2019Review
- Pharmacogenetics of warfarin dosing in patients of African and European ancestry.Pharmacogenomics · 2018Review
- Evaluation ofFuture science OA · 2018Article
- Cost-Utility Study of Warfarin Genotyping in the VACHS Affiliated Anticoagulation Clinic of Puerto Rico.Puerto Rico health sciences journal · 2017Article
- Anticoagulation endpoints with clinical implementation of warfarin pharmacogenetic dosing in a real-world setting: A proposal for a new pharmacogenetic dosing approach.Clinical pharmacology and therapeutics · 2017Article
- Impact of Body Mass Index and Genetics on Warfarin Major Bleeding Outcomes in a Community Setting.The American journal of medicine · 2017Article
- A systematic analysis and comparison of warfarin initiation strategies.Pharmacogenetics and genomics · 2016Article
- Anti-platelet Therapy Resistance - Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2016Article
- Variation in genes controlling warfarin disposition and response in American Indian and Alaska Native people: CYP2C9, VKORC1, CYP4F2, CYP4F11, GGCX.Pharmacogenetics and genomics · 2015Article
- Alcohol misuse, genetics, and major bleeding among warfarin therapy patients in a community setting.Pharmacoepidemiology and drug safety · 2015Article
- Genotype and risk of major bleeding during warfarin treatment.Pharmacogenomics · 2014Article
- Genetic risk factors for major bleeding in patients treated with warfarin in a community setting.Clinical pharmacology and therapeutics · 2014Article
- Clinical applications of pharmacogenomics guided warfarin dosing.International journal of clinical pharmacy · 2013Review
- The prevalence of VKORC1 1639 G>A and CYP2C9*2*3 genotypes in patients that requiring anticoagulant therapy in Turkish population.Molecular biology reports · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAlthough multiple reports have documented the influence of CYP2C9 and VKORC1 variants on warfarin dose, risk of over-anticoagulation and hemorrhage, their influence on anticoagulation maintenance and individual proportion of time spent in target INR range (PPTR) is limited. Moreover the potential benefit of genotype-guided dosing implemented after initiation of therapy in a racially diverse population has not been explored. Herein we present the influence of CYP2C9 and VKORC1 C1173T on warfarin response during the first 30 days of therapy.
methodsWarfarin dose was empirically determined in 250 African Americans 271 European Americans. The influence of CYP2C9 and VKORC1 on rate of INR increase, anticoagulation maintenance, risk of over-anticoagulation, and change in dose over 30 days was evaluated after adjustment for socio-demographic, lifestyle and clinical factors. Possession of variant VKORC1 (+/- variant CYP2C9) genotype was associated with a more rapid attainment of target INR and higher frequency of dose adjustments. Patients possessing variant genotypes spent less time in target range. However adjustment for rate of INR increase rendered the association non-significant. European Americans (but not African Americans) possessing variant VKORC1 (+/- variant CYP2C9) genotype had a higher risk of over-anticoagulation. Neither CYP2C9 nor VKORC1 influenced the risk of minor hemorrhage. CYP2C9 and VKORC1 explained 6.3% of the variance in dose change over the first 30 days of therapy demonstrating that the usefulness of genotype-guided dosing may extend beyond first day of therapy.
conclusionThe benefit of genotype-based dose prediction may extend beyond first few days of therapy. Whether genotype-guided dosing will decrease the risk of over-anticoagulation, improve anticoagulation control and most importantly improve outcomes for chronic warfarin users remains to be proven.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.