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For: Yan X, Yang F, Zhou H, Zhang H, Liu J, Ma K, Li Y, Zhu J, Ding J. Effects of VKORC1 Genetic Polymorphisms on Warfarin Maintenance Dose Requirement in a Chinese Han Population. Med Sci Monit 2015;21:3577-84. [PMID: 26583785 PMCID: PMC4657763 DOI: 10.12659/msm.894414] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open

For:	Yan X, Yang F, Zhou H, Zhang H, Liu J, Ma K, Li Y, Zhu J, Ding J. Effects of VKORC1 Genetic Polymorphisms on Warfarin Maintenance Dose Requirement in a Chinese Han Population. Med Sci Monit 2015;21:3577-84. [PMID: 26583785 PMCID: PMC4657763 DOI: 10.12659/msm.894414] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open

Number

Cited by Other Article(s)

Altawil Y, Youssef LA. Frequencies of VKORC1-1639G>A and rs397509427 in Patients on Warfarin and Healthy Syrian Subjects. Cardiovasc Ther 2023;2023:8898922. [PMID: 38045109 PMCID: PMC10689069 DOI: 10.1155/2023/8898922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/03/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023] Open

Holail J, Mobarak R, Al-Ghamdi B, Aljada A, Fakhoury H. Association of VKORC1 and CYP2C9 single-nucleotide polymorphisms with warfarin dose adjustment in Saudi patients. Drug Metab Pers Ther 2022;37:353-359. [PMID: 36476275 DOI: 10.1515/dmpt-2022-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/14/2022] [Indexed: 12/13/2022]

Holail J, Mobarak R, Al-Ghamdi B, Aljada A, Fakhoury H. Association of VKORC1 and CYP2C9 single-nucleotide polymorphisms with warfarin dose adjustment in Saudi patients. Drug Metab Pers Ther 2022;0:dmdi-2022-0108. [PMID: 35365981 DOI: 10.1515/dmdi-2022-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/14/2022] [Indexed: 11/15/2022]

Guo C, Kuang Y, Zhou H, Yuan H, Pei Q, Li J, Jiang W, Ng CM, Chen X, Huo Y, Cui Y, Wang X, Yu J, Sun X, Yu W, Chen P, Miao D, Liu W, Yu Z, Ouyang Z, Shi X, Lv C, Peng Z, Xiong G, Zeng G, Zeng J, Dai H, Peng J, Zhang Y, Xu F, Wu J, Chen X, Gong H, Yang Z, Wu X, Fang Q, Yang L, Li H, Tan H, Huang Z, Tang X, Yang Q, Tu S, Wang X, Xiang Y, Huang J, Wang X, Cai J, Jiang S, Huang L, Peng J, Gong L, Zou C, Yang G. Genotype-Guided Dosing of Warfarin in Chinese Adults: A Multicenter Randomized Clinical Trial. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2020;13:e002602. [PMID: 32510984 PMCID: PMC7439928 DOI: 10.1161/circgen.119.002602] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]

Abstract

BACKGROUND

Warfarin is an effective treatment for thromboembolic disease but has a narrow therapeutic index; optimal anticoagulation dosage can differ tremendously among individuals. We aimed to evaluate whether genotype-guided warfarin dosing is superior to routine clinical dosing for the outcomes of interest in Chinese patients.

METHODS

We conducted a multicenter, randomized, single-blind, parallel-controlled trial from September 2014 to April 2017 in 15 hospitals in China. Eligible patients were ≥18 years of age, with atrial fibrillation or deep vein thrombosis without previous treatment of warfarin or a bleeding disorder. Nine follow-up visits were performed during the 12-week study period. The primary outcome measure was the percentage of time in the therapeutic range of the international normalized ratio during the first 12 weeks after starting warfarin therapy.

RESULTS

A total of 660 participants were enrolled and randomly assigned to a genotype-guided dosing group or a control group under standard dosing. The genotype-guided dosing group had a significantly higher percentage of time in the therapeutic range than the control group (58.8% versus 53.2% [95% CI of group difference, 1.1-10.2]; P=0.01). The genotype-guided dosing group also achieved the target international normalized ratio sooner than the control group. In subgroup analyses, warfarin normal sensitivity group had an even higher percentage of time in the therapeutic range during the first 12 weeks compared with the control group (60.8% versus 48.9% [95% CI, 1.1-24.4]). The incidence of adverse events was low in both groups.

CONCLUSIONS

The outcomes of genotype-guided warfarin dosing were superior to those of clinical standard dosing. These findings raise the prospect of precision warfarin treatment in China. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02211326.

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Affiliation(s)

Chengxian Guo Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China.,Department of Pharmacy (C.G., Q.P., L.H., Jinfu Peng, G.Y.), Central South University, Changsha, China.,Research Center of Drug Clinical Evaluation (C.G., Y.K., G.Y.), Central South University, Changsha, China
Yun Kuang Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China.,Research Center of Drug Clinical Evaluation (C.G., Y.K., G.Y.), Central South University, Changsha, China
Honghao Zhou Department of Clinical Pharmacology, Xiangya Hospital (H.Z., Xiaoping Chen), Central South University, Changsha, China
Hong Yuan Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Qi Pei Department of Pharmacy (C.G., Q.P., L.H., Jinfu Peng, G.Y.), Central South University, Changsha, China
Jingle Li Department of Cardiology, The Third Xiangya Hospital (J.L., W.J., X.T., Q.Y., S.T., Xiaoyan Wang, J.C., S.J.), Central South University, Changsha, China
Weihong Jiang Department of Cardiology, The Third Xiangya Hospital (J.L., W.J., X.T., Q.Y., S.T., Xiaoyan Wang, J.C., S.J.), Central South University, Changsha, China
Chee M Ng College of Pharmacy, University of Kentucky, Lexington (C.M.N.)
Xiaoping Chen Department of Clinical Pharmacology, Xiangya Hospital (H.Z., Xiaoping Chen), Central South University, Changsha, China.,Institute of Clinical Pharmacology, Hunan Key Laboratory of Pharmacogenetics (Xiaoping Chen)
Yong Huo Department of Cardiology (Y.H.), Peking University Health Science Center, Beijing, China
Yimin Cui Department of Pharmacy, Peking University First Hospital (Y.C.), Peking University Health Science Center, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences (Y.C.), Peking University Health Science Center, Beijing, China
Xiaobin Wang Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (Xiaobin Wang).,Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (Xiaobin Wang)
Jingjing Yu Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Xue Sun Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Wanying Yu Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Peng Chen Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Da Miao Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Wenyu Liu Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Zaixin Yu Department of Cardiology, Third Hospital of Changsha, China (Y.Z.)
Zewei Ouyang Department of Cardiology, Shaoyang Central Hospital, China (Z.O., X. Shi)
Xiangjiang Shi Department of Cardiology, Shaoyang Central Hospital, China (Z.O., X. Shi)
Chunmei Lv Department of Cardiology, The First People's Hospital of Shaoyang, China (C.L., Z.P.)
Zijing Peng Department of Cardiology, The First People's Hospital of Shaoyang, China (C.L., Z.P.)
Guozuo Xiong Department of Vascular Surgery (G.X.), The Second Affiliated Hospital, University of South China, Hengyang
Gaofeng Zeng Department of Cardiology (G.Z.), The Second Affiliated Hospital, University of South China, Hengyang
Jianping Zeng Department of Cardiology, Xiangtan Central Hospital, China (J.Z.)
Haiying Dai Department of Cardiology, Changsha Central Hospital, China (H.D.)
Jianqiang Peng Department of Cardiology, Hunan Provincial People's Hospital, China (Jianqiang Peng)
Yuming Zhang Department of Cardiology, Third Hospital of Changsha, China (Y.Z.)
Fanghua Xu Department of Cardiology, First People's Hospital of Xiangtan City, China (F.X.)
Jie Wu Department of Cardiology, First Affiliated Hospital of University of South China, Hengyang (J.W.)
Xiaoliang Chen Department of Cardiology, Chenzhou First People's Hospital, China (Xiaoliang Chen)
Hao Gong Department of Cardiology, The Fourth Hospital of Changsha, China (H.G.)
Zhiyuan Yang Department of Cardiology, Loudi Central Hospital, China (Z. Yang)
Xianming Wu Department of Cardiology, Yiyang Central Hospital, China (X. Wu)
Qiulian Fang School of Mathematics and Statistics (Q.F., L.Y.), Central South University, Changsha, China
Liu Yang School of Mathematics and Statistics (Q.F., L.Y.), Central South University, Changsha, China
Haigang Li Department of Pharmacy, Changsha Medical University, China (H.L.)
Hongyi Tan Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Zhijun Huang Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Xiaohong Tang Department of Cardiology, The Third Xiangya Hospital (J.L., W.J., X.T., Q.Y., S.T., Xiaoyan Wang, J.C., S.J.), Central South University, Changsha, China
Qiong Yang Department of Cardiology, The Third Xiangya Hospital (J.L., W.J., X.T., Q.Y., S.T., Xiaoyan Wang, J.C., S.J.), Central South University, Changsha, China
Shan Tu Department of Cardiology, The Third Xiangya Hospital (J.L., W.J., X.T., Q.Y., S.T., Xiaoyan Wang, J.C., S.J.), Central South University, Changsha, China
Xiaoyan Wang Department of Cardiology, The Third Xiangya Hospital (J.L., W.J., X.T., Q.Y., S.T., Xiaoyan Wang, J.C., S.J.), Central South University, Changsha, China
Yuxia Xiang Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Jie Huang Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Xiaomin Wang Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Jingjing Cai Department of Cardiology, The Third Xiangya Hospital (J.L., W.J., X.T., Q.Y., S.T., Xiaoyan Wang, J.C., S.J.), Central South University, Changsha, China
Shanjie Jiang Department of Cardiology, The Third Xiangya Hospital (J.L., W.J., X.T., Q.Y., S.T., Xiaoyan Wang, J.C., S.J.), Central South University, Changsha, China
Lu Huang Department of Pharmacy (C.G., Q.P., L.H., Jinfu Peng, G.Y.), Central South University, Changsha, China
Jinfu Peng Department of Pharmacy (C.G., Q.P., L.H., Jinfu Peng, G.Y.), Central South University, Changsha, China
Liying Gong Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Chan Zou Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China
Guoping Yang Center of Clinical Pharmacology, the Third Xiangya Hospital (C.G., Y.K., H.Y., J.Y., X. Sun, W.Y., P.C., D.M., W.L., H.T., Z.H., Y.X., J.H., Xiaomin Wang, L.G., C.Z., G.Y.), Central South University, Changsha, China.,Department of Pharmacy (C.G., Q.P., L.H., Jinfu Peng, G.Y.), Central South University, Changsha, China.,Research Center of Drug Clinical Evaluation (C.G., Y.K., G.Y.), Central South University, Changsha, China

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Fereidouni M, Moossavi M, Kazemi T, Nouranihassankiade S, Asghari A. Association between polymorphisms of VKORC1 and CYP2C9 genes with warfarin maintenance dose in a group of warfarin users in Birjand city, Iran. J Cell Biochem 2018;120:9588-9593. [PMID: 30525241 DOI: 10.1002/jcb.28235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/15/2018] [Indexed: 01/05/2023]

Li J, Yang W, Xie Z, Yu K, Chen Y, Cui K. Impact of VKORC1, CYP4F2 and NQO1 gene variants on warfarin dose requirement in Han Chinese patients with catheter ablation for atrial fibrillation. BMC Cardiovasc Disord 2018;18:96. [PMID: 29776386 PMCID: PMC5960187 DOI: 10.1186/s12872-018-0837-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 05/09/2018] [Indexed: 02/05/2023] Open

Abstract

Background

The anticoagulation of atrial fibrillation catheter ablation during the perioperative stage does matter and should be treated with discretion. We aimed to assess impact of three important genes participating in vitamin K cycle (i.e. VKORC1 rs9923231, CYP4F2 rs2108622 and NQO1 rs1800566) on the daily stable warfarin dose requirement in Sichuan Han Chinese patients with catheter ablation of atrial fibrillation.

Methods

A total of 222 atrial fibrillation patients taking stable warfarin therapy after catheter ablation operation were enrolled in this study. The study population included had high (≥2) risk according to the CHA2DS2-VASc risk score. Genotypes of VKORC1 rs9923231, CYP4F2 rs2108622 and NQO1 rs1800566 were analyzed by using the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). Multiple linear regression analysis was applied to depict the impact of VKORC1 rs9923231, CYP4F2 rs2108622 and NQO1 rs1800566 on the daily stable warfarin dose requirement.

Results

Carriers of VKORC1 rs9923231 AG/GG genotypes required significantly higher warfarin dose (3.03 ± 0.28 mg/day, 7.19 mg/day, respectively) than AA carriers (2.52 ± 0.07 mg/day; P < 0.001). Carriers of CYP4F2 rs2108622 CT/TT genotypes required significantly higher warfarin dose (3.38 ± 0.22 mg/day, 2.79 ± 0.19 mg/day, respectively) than CC carriers (2.41 ± 0.08 mg/day; P < 0.001). However, the warfarin dose for carriers of NQO1 rs1800566 CT/TT genotypes (2.46 ± 0.24 mg/day, 3.01 ± 0.27 mg/day, respectively) was not significantly higher than that for the CC carriers (2.33 ± 0.1 mg/day). The multiple linear regression model including genotypes and demographic characteristics, could explain 20.1% of individual variations in the daily stable warfarin dose in Sichuan Han Chinese. VKORC1 rs9923231 contributed most (15%) to the individual variations in daily stable warfarin dose, while CYP4F2 rs2108622 contributed least (3%).

Conclusion

NQO1 rs1800566 is not a significant genetic factor of warfarin dose for Han Chinese, whereas VKORC1 rs9923231 and CYP4F2 rs2108622 are significant genetic factors, which could explain 15% and approximately 3% of individual variations in the daily stable warfarin dose respectively.

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Impact of CYP2C19 gene polymorphism on warfarin maintenance doses in patients with non-valvular atrial fibrillation. Gene 2016;591:80-84. [DOI: 10.1016/j.gene.2016.06.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 05/30/2016] [Accepted: 06/22/2016] [Indexed: 12/30/2022]