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Warfarin is considered as one of the most common anticoagulation drugs in the world. However, Because of wide dosage variation in different patients, lack of wide therapeutic index and risk of bleeding complications, treatment with this drug must be done very wisely. Recognition of high and low dose people is of high importance in this regard. Between these two groups, low-dose are more likely to face difficulties in major bleeding complications in receiving warfarin. Optimizing dosage of warfarin has remained a challenge in the clinical setting. Among existing methods, genotyping may be considered as a suitable one in order to assess warfarin dosing. But, all of genetic polymorphisms cannot be detected in the target gene and the analysis with genotyping can be time consuming. So for more effective warfarin therapy, pharmacogenomics and pharmacoproteomics should be combined. Specific proteins (biomarkers) present in either lowor high-dose patients may represent an added advantage. The combination of both genotyping and biomarkers may further improve the accuracy of the prognosis. In this study, in order to find significant biomarker, 56 patients requiring low and high dose of warfarin treatment were selected. Their sera samples were then analyzed by iTRAQ-coupled LC-MS/MS analysis in three independent experiments. We found Transthyretin precursor protein which is significantly different among the patients requiring low and high warfarin dose. ATTENTION: The Singapore Copyright Act applies to the use of this document. Nanyang Technological University Library

LC-MS/MS analysis of drug dosage and genetic polymorphism in patients on anti-coagulant warfarin treatment : potential in biomarker identification