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Genetic and Clinical Predictors of Warfarin Dose Requirements in African Americans

Authors: L H, Cavallari; T Y, Langaee; K M, Momary; N L, Shapiro; E A, Nutescu; W A, Coty; M A G, Viana; +2 Authors

Genetic and Clinical Predictors of Warfarin Dose Requirements in African Americans

Abstract

The objective of this study was to determine whether, in African-American patients, additional vitamin K oxidoreductase complex subunit 1 (VKORC1), cytochrome P450 2C9 (CYP2C9), CYP4F2, or apolipoprotein E (APOE) polymorphisms contribute to variability in the warfarin maintenance dose beyond what is attributable to the CYP2C9*2 and *3 alleles and the VKORC1 -1639G>A genotype. In a cohort of 226 African-American patients, weekly warfarin dose requirements were lower in those with the CYP2C9*8 allele (34 (30-47) mg; P = 0.023) and the CYP2C9 *2, *3, *5, *6, or *11 allele (33(28-40 mg); P A genotype, and clinical variables explained 36% of the interpatient variability in warfarin dose requirements. By comparison, a model without the CYP2C9*5, *6, *8, and *11 alleles explained 30% of the variability in dose. No other VKORC1, CYP4F2, or APOE polymorphism contributed to the variance. The inclusion of additional CYP2C9 variants may improve the predictive ability of warfarin dosing algorithms for African Americans.

Related Organizations
Keywords

Adult, Male, Polymorphism, Genetic, Dose-Response Relationship, Drug, Genotype, Anticoagulants, Middle Aged, Mixed Function Oxygenases, Black or African American, Apolipoproteins E, Vitamin K Epoxide Reductases, Humans, Female, Aryl Hydrocarbon Hydroxylases, Warfarin, Algorithms, Alleles, Aged, Cytochrome P-450 CYP2C9

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Powered by OpenAIRE graph
citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
191
Top 10%
Top 10%
Top 1%