Evaluation of Pharmacogenetic Algorithm for Warfarin Dose Requirements in Japanese Patients

• Takeuchi Fumihiko

  Department of Gene Diagnostics and Therapeutics, Research Institute, International Medical Center of Japan

• Kashida Mitsuo

  Division of Cardiology, International Medical Center of Japan

• Okazaki Osamu

  Division of Cardiology, International Medical Center of Japan

• Tanaka Yuriko

  Division of Cardiology, International Medical Center of Japan

• Fukuda Shoji

  Division of Cardiovascular Surgery, International Medical Center of Japan

• Kashima Toshitaka

  Division of Cardiovascular Surgery, International Medical Center of Japan

• Hosaka Shigeru

  Division of Cardiovascular Surgery, International Medical Center of Japan

• Hiroe Michiaki

  Division of Cardiology, International Medical Center of Japan

• Kimura Sosuke

  Division of Cardiovascular Surgery, International Medical Center of Japan Toyama Hospital, International Medical Center of Japan

• Kato Norihiro

  Department of Gene Diagnostics and Therapeutics, Research Institute, International Medical Center of Japan Division of Cardiology, International Medical Center of Japan

抄録

Background: Warfarin dosing is difficult to establish because of considerable interindividual variation. Thus, warfarin pharmacogenetics have attracted particular interest in relation to appropriate control of anticoagulation. Methods and Results: The 200 eligible subjects were chosen from participants in a hospital cohort. Performance of a pharmacogenetic algorithm recently developed by the International Warfarin Pharmacogenetics Consortium (IWPC) was tested and compared with a clinical algorithm (without genotype data) by calculating the percentage of patients for whom the predicted dose deviated by less than 7 mg/week (1 mg/day) from the actual dose. The pharmacogenetic algorithm accurately identified a significantly (P<0.05) larger proportion of patients to achieve the target international normalized ratio than did the clinical algorithm (68% vs 36% for a low-dose group; and 21% vs 0% for a high-dose group). Also, an increase in warfarin dosage was found to be appropriate for the current status of alcohol drinking (4 mg/week, as against non-drinking) and smoking (3.3 mg/week, as against non-smoking). Conclusions: The IWPC pharmacogenetic algorithm has clinical application, particularly in identifying Japanese patients who require a low dosage of warfarin and are at greater risk of excessive anticoagulation. (Circ J 2010; 74: 977 - 982)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 74 (5), 977-982, 2010

  一般社団法人 日本循環器学会

キーワード

• Anticoagulation
• <i>CYP2C9</i>
• Pharmacogenetics
• <i>VKORC1</i>
• Warfarin

詳細情報

• CRID: 1390282680079322752
• NII論文ID: 10026473823
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-09-0876
• ISSN: 13474820
• ISSN: 13469843
• Web Site: http://www.jstage.jst.go.jp/article/circj/74/5/74_CJ-09-0876/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2010265654
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可