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Purpose: The aim of this study was to investigate whether any of the single-nucleotide polymorphisms (SNPs) in the POR gene were significantly associated with CYP activity and expression, and could contribute to the total variability in stable warfarin maintenance doses in Han Chinese.
Methods: A total of 408 patients treated at the First Affiliated Hospital of Sun Yat-Sen University were eligible for the study and had attained a stable warfarin maintenance dose at the start of the investigation. Demographics, warfarin maintenance doses, and concomitant medications were documented. Genomic DNA was extracted from peripheral blood samples and genotyped for ten SNPs (CYP 2C9*2 and *3, CYP4F2 rs2108622, VKORC1 -1639C>T, and potential POR genes of rs10239977, rs3815455, rs41301394, rs56256515, rs1057868, and rs2286823) using the Sequenom MassARRAY genotyping system.
Results: A predictive model of warfarin maintenance dose was established and indicated that age, gender, body surface area, aspirin use, CYP2C9*3, CYP4F2 rs2108622, VKORC1 -1639C>T, and POR*37 831-35C>T accounted for 42.4 % of dose variance in patients undergoing anticoagulant treatment. The contribution of POR*37 831-35C>T to warfarin dose variation was only 3.9 %.
Conclusions: For the first time, the SNP POR*37 831-35C>T was confirmed as a minor but statistically significant factor associated with interindividual variation in warfarin maintenance dose in Han Chinese. The POR*37 gene polymorphism should be considered in future algorithms for faster and more reliable achievement of stable warfarin maintenance doses.
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http://dx.doi.org/10.1007/s00228-016-2098-x | DOI Listing |
Introduction: Warfarin is a narrow therapeutic index drug that requires frequent monitoring using the international normalized ratio (INR). Current clinic-based INR monitoring models lead to suboptimal warfarin management. Warfarin patient self-management (PSM) has consistently demonstrated superior efficacy compared to clinic-based management but is virtually unused in the US healthcare system.
View Article and Find Full Text PDFJ Surg Res
August 2025
Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address:
Introduction: Our study aimed to compare the impact of pharmacist-led genotype-guided warfarin dosing with the traditional dosing regimen on the anticoagulation effect for patients undergoing valve replacement.
Methods: A total of 453 patients were divided into genotype-guided and traditional dosing groups. Blood samples were obtained for genotyping and determination of warfarin dosing by an algorithm in the genotype group, while a regular dose was administered in the traditional group.
Rev Cardiovasc Med
June 2025
Center of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, 100000 Beijing, China.
Background: The narrow therapeutic range of warfarin, alongside the response of numerous influencing factors and significant inter-individual variability, presents major challenges for personalized medication. This study aimed to combine clinical and genetic characteristics with machine learning (ML) algorithms to develop and validate a model for predicting stable warfarin doses in patients from Northern China after mechanical heart valve replacement surgery.
Methods: This study included patients who underwent mechanical heart valve replacement surgery at the Beijing Anzhen Hospital between January 2021 and January 2024 and achieved a stable warfarin maintenance dose.
J Transl Med
July 2025
Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia.
Background: Understanding interindividual variability in medication dosing is central to precision medicine. Despite significant pharmacogenomic (PGx) insights into key biological pathways influencing drug response, the polygenic contribution to dose variability and the potential of electronic health records for maintenance dose estimation remain largely unexplored.
Methods: We leveraged longitudinal drug purchase data linked to the Estonian Biobank (N = 212,000) to derive individual-level daily doses per purchase as well as median and maximum doses as consolidated metrics across purchases for cardiovascular and psychiatric drugs: statins, warfarin, metoprolol, antidepressants, and antipsychotics.
Dan Med J
June 2025
Center of Excellence for Anticoagulant Treatment, Department of Cardiology, Copenhagen University Hospital - Bispebjerg and Frederiksberg Hospital, Denmark.
Introduction: Patients on warfarin are normally required to interrupt treatment for a fixed number of days prior to an invasive procedure. This study aimed to investigate the potential influence of the warfarin maintenance dose and the initial international normalised ratio (INR) level on the duration of the break required to achieve the planned target INR.
Methods: A total of 120 patients on self-managed warfarin treatment measured INR once daily for five days before the intervention and were guided by the anticoagulation clinic on when to discontinue warfarin.