Open AccessGenetic polymorphisms and dosing of vitamin K antagonist in Indian patients after heart valve surgery
Author(s) -
Shiv Kumar Choudhary,
Anoop Mathew,
Amit Parhar,
Milind Padmakar Hote,
Sachin Talwar,
Palleti Rajashekhar
Publication year - 2019
Publication title -
indian journal of thoracic and cardiovascular surgery/indian journal of thoracic and cardiovascular surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.114
H-Index - 9
eISSN - 0973-7723
pISSN - 0970-9134
DOI - 10.1007/s12055-019-00812-3
Subject(s) - vkorc1 , acenocoumarol , cyp2c9 , warfarin , vitamin k epoxide reductase , vitamin k antagonist , medicine , pharmacology , cardiac surgery , genotype , gastroenterology , biology , atrial fibrillation , genetics , cytochrome p450 , gene , metabolism
Vitamin K antagonists (VKAs), such as warfarin and acenocoumarol, exert their anti-coagulant effect by inhibiting the subunit 1 of vitamin K epoxide reductase complex (VKORC1). CYP2C9 is a hepatic drug-metabolizing enzyme in the CYP450 superfamily and is the primary metabolizing enzyme of warfarin. Three single nucleotide polymorphisms, two in the CYP2C9 gene, namely CYP2C9*2 and CYP2C9*3, and one in the VKORC1 gene (c.- 1639G > A, rs9923231), have been identified to reduce VKA metabolism and enhance their anti-coagulation effect. The purpose of this study is to evaluate the prevalence of CYP2C9 and VKORC1 polymorphism in Indians receiving VKA-based anti-coagulation after valve surgery and to evaluate the usefulness of genetic information in managing VKA-based anti-coagulation.