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Journal articles on the topic 'CYP2CP; VKORC1; Thromboembolism'

Author: Grafiati

Published: 3 June 2025

Last updated: 31 July 2025

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1

RanakishorPelluri*, Panguluri Haripriya Mantri Satyavathi V. Lakshmi Prasanna Shaik SeshmaIfthulla P.SrinivasaBabu. "WARFARIN DOSAGE ADJUSTMENT IN PATIENTS WITH GENETIC VARIABILITY." INDO AMERICAN JOURNAL OF PHARMACEUTICAL RESEARCH 07, no. 09 (2017): 488–91. https://doi.org/10.5281/zenodo.1036431.

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Warfarin is a potent drug that when used judiciously and monitored closely, leads to substantial reductions in morbidity and mortality from thromboembolic events. However, even with careful monitoring, initiation of warfarin dosing is associated with highly variable responses between individuals and challenges achieving and maintaining levels within the narrow therapeutic range that can lead to adverse drug events. Genetic factors most correlated with warfarin dose requirements are variations in the genes encoding the enzymes cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase (VKOR).

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Anekella, Bharathi, Jainlei Wu, Catherine Huang, et al. "Characterization and Development of Genomic DNA Quality Controls for Thrombophilia and Warfarin Sensitivity Testing." Blood 112, no. 11 (2008): 4679. http://dx.doi.org/10.1182/blood.v112.11.4679.4679.

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Abstract Background: Genetic tests for diagnosis of clotting disorders and monitoring their treatment are based on identification of single nucleotide polymorphisms (SNPs) that are related respectively to clotting and to drug metabolism crucial to the effectiveness of therapy. Thrombophilia, an inherited condition which predisposes to thromboembolism, is due in part to genetic factors, such as the presence of SNPs in the genes encoding clotting factors. Hyperhomocysteinemia, which poses an extremely elevated risk of thromboembolism to the patient, can be caused by certain mutations to the MTHF

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Gong, Inna Y., Rommel G. Tirona, Ute I. Schwarz, et al. "Prospective evaluation of a pharmacogenetics-guided warfarin loading and maintenance dose regimen for initiation of therapy." Blood 118, no. 11 (2011): 3163–71. http://dx.doi.org/10.1182/blood-2011-03-345173.

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Abstract Single-nucleotide polymorphisms in genes that affect warfarin metabolism (cytochrome P450 2C9 gene, CYP2C9) and response (vitamin K epoxide reductase complex 1 gene, VKORC1) have an important influence on warfarin therapy, particularly during initiation; however, there is a lack of consensus regarding the optimal pharmacogenetics-based initiation strategy. We conducted a prospective cohort study in which patients requiring warfarin therapy for atrial fibrillation or venous thromboembolism were initiated with a novel pharmacogenetics-initiation protocol (WRAPID, Warfarin Regimen using

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Tzveova, R., R. Saraeva, A. Dimitrova-Karamfilova, et al. "Establishment of Acenocoumarol Pharmacogenetic Algorithm Including CYP2C9 and VKORC1 Genotypes in Bulgarian Patients Treated with Coumarin Anticoagulants." Acta Medica Bulgarica 52, no. 2 (2025): 12–23. https://doi.org/10.2478/amb-2025-0039.

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Abstract Introduction Acenocoumarol, a 4-hydroxycoumarin derivative, is widely prescribed for the primary and secondary prevention of thromboembolic disorders. Maintenance dosing of acenocoumarol is significantly influenced by polymorphic variants in the CYP2C9 and VKORC1 genes. Other critical factors affecting dosing include patient age, diet, body height and weight, and potential drug interactions, particularly with concurrent use of medications such as amiodarone and statins. Objectives The primary goal of this investigation is to develop a pharmacogenetic dosing algorithm for acenocoumarol

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Tanaka, Tomotaka, Masafumi Ihara, Kazuki Fukuma, et al. "Influence of Renal Impairment and Genetic Subtypes on Warfarin Control in Japanese Patients." Genes 12, no. 10 (2021): 1537. http://dx.doi.org/10.3390/genes12101537.

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The genotypes of vitamin K epoxide reductase complex 1 (VKORC1) and cytochrome P450 2C9 (CYP2C9) can influence therapeutic warfarin doses. Conversely, nongenetic factors, especially renal function, are associated with warfarin maintenance doses; however, the optimal algorithm for considering genes and renal dysfunction has not been established. This single-center prospective cohort study aimed to evaluate the factors affecting warfarin maintenance doses and develop pharmacogenetics-guided algorithms, including the factors of renal impairment and others. To commence, 176 outpatients who were pr

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YAY, Kerem, Alper İbrahim TOSYA, and Zafer Cengiz ER. "DO VKORC1 AND CYP2C9 MUTATIONS LEAD TO WARFARIN RESISTANCE?" Euroasia Journal of Mathematics, Engineering, Natural & Medical Sciences 8, no. 18 (2021): 100–104. http://dx.doi.org/10.38065/euroasiaorg.768.

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The objective of this study was to determine the influence of VKORC1 and CYP2C9 polymorphisms on warfarin resistant patients. Warfarin resistance is described as the inability to prolong the prothrombin time or raise the INR up to the 2 therapeutic range when the drug is given at typically doses. Polymorphisms may play a role as some VKORC1 and CYP2C9 variant alleles are known to be associated with these circumstances. 28 patients who were taking warfarin more than 15 mg/day and had INR values below 2.1 and had thromboembolic events while using warfarin were enrolled in this study. Heterozygot

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Jiménez-Varo, Enrique, Marisa Cañadas-Garre, María José Gutiérrez-Pimentel, Cristina Isabel Henriques, Ana Margarida Pinheiro, and Miguel Ángel Calleja-Hernández. "Pharmacogenetics role in the safety of acenocoumarol therapy." Thrombosis and Haemostasis 112, no. 09 (2014): 522–36. http://dx.doi.org/10.1160/th13-11-0941.

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SummaryVitamin K antagonists (VKAs) remain as the most prescribed drug for treatment and prevention of thrombotic disorders in many countries, despite the recent approval of the new oral anticoagulants (NOACs). Although effectiveness and safety of VKAs are tightly associated to maintaining the patient within the international normalised ratio (INR) therapeutic range (TWR), they have been likened to NOACs when patients are in good INR control (≥66% of TWR). Therefore, assessing the safety of patients should be a priority in the selection of the anticoagulation therapy. The aim of this study was

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Georgieva, K. S., and S. I. Pavlova. "Prevalence of CYP2C9 and VKORC1 polymorphism carriage in patients of the Chuvash population receiving warfarin." Glavvrač (Chief Medical Officer), no. 4 (March 22, 2025): 37–38. https://doi.org/10.33920/med-03-2504-06.

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Warfarin is an anticoagulant with proven efficacy in preventing thromboembolic complications in patients with mechanical heart valves. Genetic characteristics of the patient, such as carriage of polymorphisms responsible for its pharmacokinetics (CYP2C9) and pharmacodynamics (VKORC1) are significant when selecting doses of this drug.

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Николаев, Е. Е., А. В. Богданов, С. И. Павлова, and С. М. Богданова. "Clinical Case of Warfarin Resistance in a Patient with Prosthetic Heart Valves and the CYP2C9*1*1-VKORC1GG Genotype." Кардиология в Беларуси, no. 3 (July 13, 2020): 432–38. http://dx.doi.org/10.34883/pi.2020.12.3.011.

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Использование непрямых антикоагулянтов, в частности варфарина, является обязательным для профилактики тромбозов у пациентов с протезированными клапанами сердца. В статье представлен клинический случай резистентности к варфарину у пациента с имплантированными митральным и аортальным клапанами. В период его стационарного лечения наблюдались трудности в подборе дозы варфарина для достижения целевого международного нормализованного отношения (МНО), отмечались тромбоэмболические и геморрагические осложнения. В публикации рассмотрены генетические и другие факторы, с которыми могла быть связана устой

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Gage, B. F., C. S. Eby, J. A. Johnson, et al. "Use of Pharmacogenetics and Clinical Factors To Predict the Maintenance Dose of Warfarin." Blood 106, no. 11 (2005): 550. http://dx.doi.org/10.1182/blood.v106.11.550.550.

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Abstract Background Initiation of warfarin therapy using trial-and-error dosing can cause bleeding. Clinical factors explain only 20%–30% of the variability in the therapeutic dose of warfarin. Single nucleotide polymorphisms (SNPs) in the cytochrome P450 2C9 (CYP2C9) gene correlate with the clearance of S-warfarin and SNPs in the vitamin K epoxide reductase (VKORC1) gene predict warfarin sensitivity. We test the hypothesis that the combination of clinical and pharmacogenetic information can predict the therapeutic warfarin dose. Methods We collected DNA, demographic variables, laboratory valu

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Rai, Alex J., Nitin Udar, Rana Saad, and Martin Fleisher. "A Multiplex Assay for Detecting Genetic Variations in CYP2C9, VKORC1, and GGCX Involved in Warfarin Metabolism." Clinical Chemistry 55, no. 4 (2009): 823–26. http://dx.doi.org/10.1373/clinchem.2008.118497.

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Abstract Background: Patients differ in responses to warfarin, which is commonly prescribed to treat thromboembolic events. Genetic variations in the cytochrome P450, family 2, subfamily C, polypeptide 9 (CYP2C9), vitamin K epoxide reductase complex, subunit 1 (VKORC1), and gamma-glutamyl carboxylase (GGCX) genes have been shown to contribute to impaired metabolism of warfarin. Methods: We designed a custom multiplex single-nucleotide polymorphism (SNP) panel to interrogate the CYP2C9 *2, *3, VKORC1 (–1639G→A), and GGCX (1181T→G) alleles simultaneously in a single sample by use of single-base

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Bevans, Carville, Andreas Fregin, Christof Geisen, Clemens Müller-Reible, Matthias Watzka, and Johannes Oldenburg. "Current pharmacogenetic developments in oral anticoagulation therapy: The influence of variant VKORC1 and CYP2C9 alleles." Thrombosis and Haemostasis 98, no. 09 (2007): 570–78. http://dx.doi.org/10.1160/th07-07-0454.

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SummaryFor decades coumarins have been the most commonly prescribed drugs for therapy and prophylaxis of thromboembolic conditions. Despite the limitation of their narrow therapeutic dosage window, the broad variation of intra- and inter-individual drug requirement, and the relatively high incidence of bleeding complications,prescriptions for coumarins are increasing due to the aging populations in industrialised countries.The identification of the molecular target of coumarins,VKORC1, has greatly improved the understanding of coumarin treatment and illuminated new perspectives for a safer and

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Moreau, Caroline, Eric Pautas, Isabelle Gouin-Thibault, Jean-Louis Golmard, Marie-Anne Loriot, and Virginie Siguret. "Does VKORC1 and CYP2C9 Genotyping Help to Predict the Maintenance Dose In Elderly Inpatients at Warfarin Treatment Initiation?" Blood 116, no. 21 (2010): 189. http://dx.doi.org/10.1182/blood.v116.21.189.189.

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Abstract Abstract 189 In frail elderly patients, the low warfarin maintenance dose requirements and high risk of thrombosis and bleeding raise specific challenges, especially at treatment initiation. Because of a narrow therapeutic index and a marked interindividual variability in dosage requirements, warfarin induction doses must be tailored to individual and disease-specific factors. The aim of our multicenter study was to investigate whether VKORC1 and CYP2C9 genotypes helped to predict the warfarin maintenance dose when added to demographic, clinical data and INR values prospectively colle

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Aomori, Tohru, Koujirou Yamamoto, Atsuko Oguchi-Katayama, et al. "Rapid Single-Nucleotide Polymorphism Detection of Cytochrome P450 (CYP2C9) and Vitamin K Epoxide Reductase (VKORC1) Genes for the Warfarin Dose Adjustment by the SMart-Amplification Process Version 2." Clinical Chemistry 55, no. 4 (2009): 804–12. http://dx.doi.org/10.1373/clinchem.2008.115295.

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Abstract Background: Polymorphisms of the CYP2C9 (cytochrome P450, family 2, subfamily C, polypeptide 9) gene (CYP2C9*2, CYP2C9*3) and the VKORC1 (vitamin K epoxide reductase complex, subunit 1) gene (−1639G&gt;A) greatly impact the maintenance dose for the drug warfarin. Prescreening patients for their genotypes before prescribing the drug facilitates a faster individualized determination of the proper maintenance dose, minimizing the risk for adverse reaction and reoccurrence of thromboembolic episodes. With current methodologies, therapy can be delayed by several hours to 1 day if genot

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Rojo, Mario, Angela Margarita Roco, Marcelo Suarez, et al. "Functionally Significant Coumarin-Related Variant Alleles and Time to Therapeutic Range in Chilean Cardiovascular Patients." Clinical and Applied Thrombosis/Hemostasis 26 (January 1, 2020): 107602962090915. http://dx.doi.org/10.1177/1076029620909154.

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Despite the development of new oral agents over the last decade, vitamin K antagonists (VKAs) remain the most widely used anticoagulants for treating and preventing thromboembolism worldwide. In Chile, the Ministry of Health indicates that acenocoumarol should be used in preference to any other coumarin. Complications of inappropriate dosing are among the most frequently reported adverse events associated with this medication. It is well known that polymorphisms in pharmacokinetic and pharmacodynamic proteins related to coumarins (especially warfarin) influence response to these drugs. This wo

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Tong, Hoi, Alberto Borobia, Manuel Quintana-Díaz, et al. "Acenocoumarol Pharmacogenetic Dosing Algorithm versus Usual Care in Patients with Venous Thromboembolism: A Randomised Clinical Trial." Journal of Clinical Medicine 10, no. 13 (2021): 2949. http://dx.doi.org/10.3390/jcm10132949.

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Patients with venous thromboembolism (VTE) require immediate treatment with anticoagulants such as acenocoumarol. This multicentre randomised clinical trial evaluated the effectiveness of a dosing pharmacogenetic algorithm versus a standard-of-care dose adjustment at the beginning of acenocoumarol treatment. We included 144 patients with VTE. On the day of recruitment, a blood sample was obtained for genotyping (CYP2C9*2, CYP2C9*3, VKORC1, CYP4F2, APOE). Dose adjustment was performed on day 3 or 4 after the start of treatment according to the assigned group and the follow-up was at 12 weeks. T

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Cerezo-Manchado, Juan J., Mario Rosafalco, Ana Antón, et al. "Creating a genotype-based dosing algorithm for acenocoumarol steady dose." Thrombosis and Haemostasis 109, no. 01 (2013): 146–53. http://dx.doi.org/10.1160/th12-08-0631.

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SummaryAcenocoumarol is a commonly prescribed anticoagulant drug for the prophylaxis and treatment of venous and arterial thromboembolic disorders in several countries. In counterpart of warfarin, there is scarce information about pharmacogenetic algorithms for steady acenocoumarol dose estimation. The aim of this study was to develop an algorithm of prediction for acenocoumarol.The algorithm was created using the data from 973 retrospectively selected anticoagulated patients and was validated in a second independent cohort adding up to 2,683 patients. The best regression model to predict stab

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Izmozherova, Nadezhda V., Muraz A. Shambatov, Artem A. Popov, Daria E. Zhuk, and Viktoria A. Solodchenko. "Pharmacogenetics of warfarin: A literature review." CardioSomatics 15, no. 3 (2024): 211–20. http://dx.doi.org/10.17816/cs631885.

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Warfarin is an oral indirect anticoagulant that is widely used for the prevention of thromboembolic events. Pharmacogenetic testing is the most promising approach to personalizing warfarin treatment. In this review, we aimed to summarize how the patients’ genetic predispositions affect the pharmacokinetics of warfarin, which determines the different dosing regimens for patients. To correctly interpret data in clinical settings, algorithms for selecting the optimal dosing regimen need to be developed that consider the patient’s age, sex, weight, height, health status, and genetic characteristic

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Wells, Philip S., Michael J. Kovacs, David Anderson, et al. "Do Genetic Contributors to Warfarin Responsiveness or Common Thrombophilias Influence the Risk of Major Bleeding in Patients on Extended Duration Vitamin K Antagonist (VKA) for Venous Thromboembolic Disease?" Blood 128, no. 22 (2016): 272. http://dx.doi.org/10.1182/blood.v128.22.272.272.

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Abstract Background: Recent studies have indicated that genetic factors such as polymorphisms in the CYP2C9 and the VKORC1 genes play an important role in vitamin K antagonist (VKA) response and perhaps bleeding. There are also data to suggest, especially for factor V Leiden, that thrombophilia may confer a decreased risk of bleeding (which could explain its persistence and high prevalence in the population). The influence of major genetic factors on risk of bleeding have not previously been evaluated in large prospective cohort studies of patients with VTE on extended (treatment after the fir

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Georgieva, Ksenia S., Svetlana I. Pavlova, and Svetlana M. Bogdanova. "PHARMACOKINETIC AND PHARMACODYNAMIC FEATURES OF THE RESPONSE TO WARFARIN THERAPY ON THE EXAMPLE OF EXCESSIVE HYPOCOAGULATION DEVELOPMENT IN A PATIENT OF THE CHUVASH POPULATION WITH A PROSTHETIC HEART VALVE." Acta medica Eurasica, no. 4 (December 26, 2022): 97–102. http://dx.doi.org/10.47026/2413-4864-2022-4-97-102.

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Atrial fibrillation remains a significant public health problem worldwide to this day, and in combination with valvular heart disease it worsens the patient's prognosis. in patients with prosthetic heart valves, the use of anticoagulants is a prerequisite to prevent thromboembolic complications. Indirect anticoagulants, in particular, Warfarin, remain the front-line therapy. This article presents a clinical case of hypersensitivity to Warfarin in a patient of the Chuvash population with an implanted mitral valve. in the postoperative period, difficulties were identified to control the target i

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Son, Kuk Hui, Seok In Lee, Chang Hu Choi, Kook Yang Park, and Chul Hyun Park. "A Rare Combination of CYP2C9*3/*3 and VKORC1 1639AA in a Patient Who Had Myxoma and Thromboembolism." Annals of Thoracic Surgery 109, no. 4 (2020): e283-e284. http://dx.doi.org/10.1016/j.athoracsur.2019.07.072.

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Conti, Valeria, Valentina Manzo, Emanuela De Bellis, et al. "Opposite Response to Vitamin K Antagonists: A Report of Two Cases and Systematic Review of Literature." Journal of Personalized Medicine 12, no. 10 (2022): 1578. http://dx.doi.org/10.3390/jpm12101578.

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Vitamin K antagonists (VKAs) are used in the prophylaxis and treatment of thromboembolic disorders. Despite a high efficacy, their narrow therapeutic window and high response variability hamper their management. Several patients experience fluctuations in dose–response and are at increased risk of over- or under-anticoagulation. Therefore, it is essential to monitor the prothrombin time/international normalized ratio to determine the so-called stable dose and to adjust the dosage accordingly. Three polymorphisms, CYP2C9∗2, CYP2C9∗3 and VKORC1-1639G>A, are associated with increased sensitivi

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Duan, Linli, Nuofu Zhang, and Chunli Liu. "A Randomized Controlled Study of the VKORC1 and CYP2C9 Genotypes in Guiding Warfarin Initial Dosing Algorithm for Pulmonary Thromboembolism." Chest 149, no. 4 (2016): A519. http://dx.doi.org/10.1016/j.chest.2016.02.541.

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Skirdenko, Yu P., and N. A. Nikolaev. "Algorithm for the Choice of Anticoagulant for Patients with Atrial Fibrillation." Rational Pharmacotherapy in Cardiology 16, no. 2 (2020): 199–205. http://dx.doi.org/10.20996/1819-6446-2020-04-16.

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Aim. To evaluate the effectiveness of the anticoagulant choice algorithm in the prevention of complications of atrial fibrillation (AF). Material and methods. Patients with AF (n=98) were included into observational prospective study. The level of adherence to treatment, risk of food interactions and presence of CYP2C9 and VKORC1 genes mutations were determined at the initial examination. These indicators were necessary to specify an eligible anticoagulant according to the evaluated algorithm. Therapy was prescribed by the attending physician. Hemorrhagic and thromboembolic complications were

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Leary, Emili, Murray Brilliant, Peggy Peissig, and Sara Griesbach. "Preliminary outcomes of preemptive warfarin pharmacogenetic testing at a large rural healthcare center." American Journal of Health-System Pharmacy 76, no. 6 (2019): 387–97. http://dx.doi.org/10.1093/ajhp/zxy072.

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Abstract Purpose As a preliminary evaluation of the outcomes of implementing pharmacogenetic testing within a large rural healthcare system, patients who received pre-emptive pharmacogenetic testing and warfarin dosing were monitored until June 2017. Summary Over a 20-month period, 749 patients were genotyped for VKORC1 and CYP2C9 as part of the electronic Medical Records and Genomics Pharmacogenetics (eMERGE PGx) study. Of these, 27 were prescribed warfarin and received an alert for pharmacogenetic testing pertinent to warfarin; 20 patients achieved their target international normalized ratio

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Just, Katja S., Catharina Scholl, Miriam Boehme, et al. "Individualized versus Standardized Risk Assessment in Patients at High Risk for Adverse Drug Reactions (The IDrug Randomized Controlled Trial)–Never Change a Running System?" Pharmaceuticals 14, no. 10 (2021): 1056. http://dx.doi.org/10.3390/ph14101056.

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The aim of this study was to compare effects of an individualized with a standardized risk assessment for adverse drug reactions to improve drug treatment with antithrombotic drugs in older adults. A randomized controlled trial was conducted in general practitioner (GP) offices. Patients aged 60 years and older, multi-morbid, taking antithrombotic drugs and at least one additional drug continuously were randomized to individualized and standardized risk assessment groups. Patients were followed up for nine months. A composite endpoint defined as at least one bleeding, thromboembolic event or d

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Stanković, Sanja, Milika Ašanin, and Nada Majkić-Singh. "The Pharmacogenetics of Cardiovascular Drugs / FARMAKOGENETIKA KARDIOVASKULARNIH LEKOVA." Journal of Medical Biochemistry 33, no. 1 (2014): 71–81. http://dx.doi.org/10.2478/jomb-2014-0003.

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Summary This article will primarily summarize the current knowledge of the pharmacogenetics of commonly used drugs for the cardiovascular system: oral anticoagulants, antiplatelet therapy and statins. Coumarin anticoagulants are widely used to treat and prevent thromboembolisms. Variations in the CYP2C9 and VKORC1 genes influence the pharmacodynamic response to coumarins. Genetic variation makes an important contribution to the variation in the response to clopidogrel, the most commonly prescribed antiplatelet treatment. Genetic polymorphisms in the CYP2C19 gene as in the paraoxonase 1 gene ar

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Gruzdeva, A. A., A. A. Khokhlov, and M. V. Ilyin. "Oral anticoagulants in the prevention of thromboembolic complications in cardiac patients: analysis of use in the Russian Federation." Kachestvennaya klinicheskaya praktika, no. 1 (May 26, 2020): 69–79. http://dx.doi.org/10.37489/2588-0519-2020-1-69-79.

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In last years, special attention has been paid in the Russian Federation (RF) to improving medical care for patients with atrial fibrillation (AF) and the prevention of thromboembolic complications (TEC). The appearance on the Russian market of new oral anticoagulants (NOAC) has become a help for doctors, however, their cost imposes restrictions on the use. A humanitarian aid drugs to medical organizations of the RF, an active information program from manufacturers over the past 1.5 years have significantly increased the use of NOAC. In different regions, a different situation arises regarding

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Cîmpan, Patricia Lorena, Romeo Ioan Chira, Mihaela Mocan, Florin Petru Anton, and Anca Daniela Farcaş. "Oral Anticoagulant Therapy—When Art Meets Science." Journal of Clinical Medicine 8, no. 10 (2019): 1747. http://dx.doi.org/10.3390/jcm8101747.

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Anticoagulant treatment is extremely important and frequently encountered in the therapy of various cardiovascular diseases. Vitamin K antagonists (VKA) are in use for the prevention and treatment of arterial and venous thromboembolism, despite the introduction of new direct-acting oral anticoagulants (NOAC). The VKA still have the clear recommendation in patients with a mechanical prosthetic heart valve replacement or moderate to severe mitral stenosis of the rheumatic origin, in deep vein thrombosis associated with congenital thrombophilia, and in cases where NOAC are prohibited by social co

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Li, Weikai, Shixuan Liu, and Shuang Li. "Structural Basis of Vitamin K Antagonism." Blood 134, Supplement_1 (2019): 482. http://dx.doi.org/10.1182/blood-2019-127324.

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The vitamin K cycle supports blood coagulation, bone mineralization, and vascular calcium homeostasis. A key enzyme in this cycle, vitamin K epoxide reductase (VKOR), is the target of vitamin K antagonists (VKAs). Despite their extensive clinical use, the dose of VKAs (e.g., warfarin) is hard to regulate and overdose can lead to fatal bleeding. Improving the dose regulation requires understanding how VKAs inhibit VKOR, which is a membrane-embedded enzyme difficult to characterize with structural and biochemical studies. Here we achieve a long-standing goal of obtaining crystal structures of hu

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Teschemaker, R., W. Lawrence, and A. K. Wutoh. "PCV45 COST-EFFECTIVENESS OF CYP2C9 AND VKORC1 GENOTYPE-GUIDED WARFARIN ANTICOAGULATION CARE: THE IMPLEMENTATION OF DISCRETE EVENT SIMULATION MODEL ON THE NATURAL HISTORY OF VENOUS THROMBOEMBOLISM." Value in Health 14, no. 3 (2011): A40. http://dx.doi.org/10.1016/j.jval.2011.02.232.

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Wells, P. S., H. Majeed, S. Kassem, et al. "A regression model to predict warfarin dose from clinical variables and polymorphisms in CYP2C9, CYP4F2, and VKORC1: Derivation in a sample with predominantly a history of venous thromboembolism." Thrombosis Research 125, no. 6 (2010): e259-e264. http://dx.doi.org/10.1016/j.thromres.2009.11.020.

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Sychev, D. V., I. V. Ignatyev, N. V. Emelyanov, et al. "CYP2C9 and VKORC1 Gene Polymorphism is Inessential for Bleeding Development under Conditions of Oral Application of Anticoagulant Acenocoumarol in Russian Patients at High Risk of Thromboembolic Complications." Bulletin of Experimental Biology and Medicine 153, no. 6 (2012): 887–89. http://dx.doi.org/10.1007/s10517-012-1851-0.

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Georgieva, Ksenia S., and Svetlana I. Pavlova. "Analysis of Recurrent Haemorrhage Against the Background of Taking Warfarin in a Female Patient of the Chuvash Population (a clinical case)." Acta medica Eurasica, no. 3 (September 30, 2024): 49–58. http://dx.doi.org/10.47026/2413-4864-2024-3-49-58.

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In order to prevent thromboembolic complications in atrial fibrillation in patients with prosthetic heart valves, Warfarin still remains a standard drug in real-life clinical practice. However, against the background of Warfarin therapy, haemorrhage is common; in some cases it can be fatal. The reason for this situation lies in a narrow therapeutic range and wide individual dosage variations of this drug. Among the factors determining the effectiveness and safety of Warfarin, modifiable (for example, drug interactions, bad habits) and non-modifiable (age, gender, genetic characteristics) ones

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Al-Momany, Nairooz H., Zeid M. Makahleh, Nadia A. Al-Omari, Hana A. Al-Sarayreh, and Rawan O. Momani. "Analysis of Factors That Interrupt With INR Control in the First Anticoagulation Clinic Monitoring Jordanian Patients." Clinical and Applied Thrombosis/Hemostasis 25 (January 1, 2019): 107602961987025. http://dx.doi.org/10.1177/1076029619870252.

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Multiple factors such as vitamin K consumption, drug interactions, herbs interactions, disease states, and alcohol intake affect international normalized ratio (INR) values and thus warfarin dosing. These variables have been described in general and for all patients in the literature. In contrast, the factors that affect INR control in a specific population are rarely studied. Being aware of these factors contributes a lot in maintaining an INR control and avoiding the supratherapeutic or subtherapeutic anticoagulation and the associated risks of hemorrhage or thromboembolism. The aim of this

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Bentsionova, K. I., Z. I. Rossokha, O. G. Ievseienkova, and N. G. Gorovenko. "Pharmacogenetic substantiation of personalized prescription of oral anticoagulants in clinical practice." Medicni perspektivi 28, no. 1 (2023): 55–68. http://dx.doi.org/10.26641/2307-0404.2023.1.275870.

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Thromboembolic diseases are of great clinical concern because of their high prevalence and consequences, which are often fatal. Despite significant progress in the prevention and treatment of thrombotic events, patients remain at risk of life-threatening bleeding episodes and other side effects arising from anticoagulant therapy, so the issue of personalizing prescriptions taking into account the genetic characteristics of patients has become urgent. The purpose of the study is to substantiate the need for patient genotype analysis in order to increase the effectiveness and safety of individua

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Bentsionova, K.I., Z.I. Rossokha, O.G. Ievseienkova, and N.G. Gorovenko. "Pharmacogenetic substantiation of personalized prescription of oral anticoagulants in clinical practice." Medicni perspektivi 28, no. 1 (2023): 55–68. https://doi.org/10.26641/2307-0404.2023.1.275870.

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Thromboembolic diseases are of great clinical concern because of their high prevalence and consequences, which are often fatal. Despite significant progress in the prevention and treatment of thrombotic events, patients remain at risk of life-threatening bleeding episodes and other side effects arising from anticoagulant therapy, so the issue of personalizing prescriptions taking into account the genetic characteristics of patients has become urgent. The purpose of the study is to substantiate the need for patient genotype analysis in order to increase the effectiveness and safety of individua

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RanakishorPelluri*, Panguluri Haripriya Mantri Satyavathi V. Lakshmi Prasanna Shaik SeshmaIfthulla P.SrinivasaBabu. "WARFARIN DOSAGE ADJUSTMENT IN PATIENTS WITH GENETIC VARIABILITY." September 30, 2017. https://doi.org/10.5281/zenodo.2526922.

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Warfarin is a potent drug that when used judiciously and monitored closely, leads to substantial reductions in morbidity and mortality from thromboembolic events. However, even with careful monitoring, initiation of warfarin dosing is associated with highly variable responses between individuals and challenges achieving and maintaining levels within the narrow therapeutic range that can lead to adverse drug events. Genetic factors most correlated with warfarin dose requirements are variations in the genes encoding the enzymes cytochrome P450 2C9 (CYP2C9) and vitamin K epoxide reductase (VKOR).

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Takao, Cheryl M., Masato Takahashi, Vera Pravica, Cheryl Barton, and Gilbert Burckhart. "Abstract 6074: Vitamin K Epoxide Reductase Genotype Alters Warfarin Dose Requirements in Pediatric Patients." Circulation 118, suppl_18 (2008). http://dx.doi.org/10.1161/circ.118.suppl_18.s_1056.

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Warfarin is an oral anticoagulant used for prevention of thromboembolism in children. Its dosing is difficult due to the narrow therapeutic index & individual variability in effective dosage. Genetic polymorphism in 2 enzymes involved in warfarin metabolism, vitamin K epoxide reductase (VKORC) & cytochrome P450 isoenzyme 2C9 (CYP2C9), have been associated with lower dose requirements in adults. Testing for these polymorphisms is now recommended and being performed to guide dosing in adult patients(pts). Currently there is no information available on these polymorphisms & warfarin d

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Thi Le Hang, Do. "The Establishing the Genotyping Method for rs1057910 on CYP2C9 and rs9923231; rs9934438 on VKORC1 in blood samples of Cardiac Valve Replacement Patients treated with acenocoumarol." VNU Journal of Science: Medical and Pharmaceutical Sciences 34, no. 2 (2018). http://dx.doi.org/10.25073/2588-1132/vnumps.4122.

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Acenocoumarol is widely prescribed for patients with risk of thromboembolism in Vietnam. A lot of study revealed that genetic polymorphisms of CYP2C9 and VKORC1 genes are the strongest genetic factors that have a high-impact upon the response of acenocoumarol. Therefore, in this study, we established the genotyping method of CYP2C9 and VKORC1 on Vietnamese cardiac valve replacement patients treated with acenocoumarol. Main method included DNA extraction from peripheral blood samples, polymerase chain reaction (PCR) for amplification of target genes, identifying the genotype by Sanger sequencin

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Kropacheva, Ekaterina. "Abstract 2870: Influence Of The Vkorc1 And Cyp2c9 Genotypes On The Frequency Of Bleeding And Maintenance Warfarin Dose In Russian Population." Stroke 43, suppl_1 (2012). http://dx.doi.org/10.1161/str.43.suppl_1.a2870.

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Purpose: Warfarin (W) is a highly effective drug for prevention and treatment of arterial and venous thromboembolic disorders. Bleeding is the most important complication of the oral anticoagulation. We investigated the genetic predictors of the bleeding complications in patients on long-term adjusted-dose W therapy. Methods: The study included 86 pts (46 male), age 62,8±10,6(SD) years receiving long-term W therapy (international normalized ratio (INR) 2-3). The observation duration was from 1 month to 1 year. CYP2C9 (CYP2C9*2 and CYP2C9*3), VKORC1 G3673A genotypes were identified by the polym

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"Positive Association of Mutations in VKORC1 and CYP2C9 Genes with Venous Thrombo-Embolism (VTE) in Indian Population: A Case Control Study." Journal of Genetic Engineering and Biotechnology Research 1, no. 2 (2019). http://dx.doi.org/10.33140/jgebr.01.02.01.

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Background: Venous thrombo-embolism (VTE) refers to a blood clot that starts in vein. It is the third most common vascular disease in the world, after myocardial infarction (MI) and stroke, affecting millions of individuals every year. Two main clinical manifestations of VTE include deep vein thrombosis (DVT) and pulmonary embolism (PE), the later one being potentially fatal. Objective: The aim of this study is to investigate whether mutations in two genes VKORC1 and CYP2C9 and subsequent changes in their plasma levels can be used to predict the risk for venous thromboembolism (VTE). Method: A

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Kim, Jae Ha, Yun Kyung Park, Suk Jae Kim, et al. "Abstract TP406: Impact Of Warfarin Pharmacogenomics In The Time In Therapeutic Range In Korean Patients With Atrial Fibrillation." Stroke 44, suppl_1 (2013). http://dx.doi.org/10.1161/str.44.suppl_1.atp406.

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Background: Warfain is highly effective for stroke prevention in patients with atrial fibrillation (AF), but also has narrow therapeutic window (usually INR 2-3). Even in clinical trials with selected, closely monitored patients, the times in therapeutic range (TTR) of those taking warfarin is less than two thirds. Single nucleotide polymorphisms in genes affecting warfarin metabolism (cytochrome-P450 2C9, CYP2C9) and response (vitamin-K epoxide reductase complex 1, VKORC1) have an important influence on warfarin therapy. Initial INR response to warfain was reportedly associated with genetic v

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Maleki, Omid, and Javad Gharechahi. "Association of VKORC1 and CYP2C9 gene polymorphisms with warfarin dose requirements in a representative Iranian population with cardiac valve replacement surgery." Pharmacogenetics and Genomics, June 13, 2025. https://doi.org/10.1097/fpc.0000000000000571.

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Background Warfarin is a commonly used oral anticoagulant for managing thromboembolic events after cardiac valve surgery. However, its optimal dose varies between individuals, often requiring trial and error to determine. This study aimed to investigate the association of polymorphisms in the CYP2C9 and VKORC1 genes with warfarin dose requirements in an Iranian population undergoing cardiac valve replacement. Materials and methods A total of 140 patients recieving warfarin after cardiac valve replacement surgery were enrolled. Patients were monitored for their daily warfarin dose and internati

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Tanaka, Tomotaka, Haruko Yamamoto, Akiko Kada, et al. "Abstract TMP106: Validation Of The Factors Affecting Basal And Fluctuating Warfarin Doses In The Same Individual Throughout The Year In Japanese Patients." Stroke 44, suppl_1 (2013). http://dx.doi.org/10.1161/str.44.suppl_1.atmp106.

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Background: Vitamin K epoxide reductase (VKORC1) and cytochrome p450 isoform (CYP2C9) genotypes contribute to basal therapeutic warfarin doses. Although safe introduction of warfarin is possible, prothrombin time-international normalized ratio (PT-INR) fluctuations requiring continuous adjustment of warfarin doses have been observed in the same patient. Of late, nongenetic factors, in particular renal function, have been associated with warfarin maintenance dose and decreased anticoagulation stability; however, the mechanism of decreased anticoagulation stability has not been identified. This

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Sundari . A, Bala Tripura, R. Sivaraj, and Sunil Kumar Pandey. "THE EFFECTS OF GENETIC AND NON GENETIC FACTORS ON WARFARIN DOSE RESPONSE IN VENOUS THROMBOEMBOLISM." INDIAN JOURNAL OF APPLIED RESEARCH, August 1, 2021, 4–5. http://dx.doi.org/10.36106/ijar/7000231.

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BACKGROUND Warfarin is the most commonly used oral anticoagulant for the treatment and prevention of thromboembolic disorders. Pharmacogenomics studies have shown that variants in CYP2C9 and VKORC1 genes are strongly and consistently associated with warfarin dose variability. METHODOLOGY In this review, we included patients on stable warfarin dose and had the genetics and non-genetics factors associated with mean warfarin dose. We searched PubMed, Medline, Scopus, Google scholar and reference lists of relevant reviews. CONCLUSION Genetic and non-genetic factors affects the dose of warfarin. Ge

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Zafari, Tahmine, Narges Ajilian, Atena Mansouri, et al. "Effect of VKORC1 Gene Polymorphism on Warfarin Response in Razavi Khorasan Province Cardiovascular Patients." International Journal of Medical Laboratory, December 7, 2020. http://dx.doi.org/10.18502/ijml.v7i4.4795.

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Background and Aims: Warfarin is an anticoagulant agent used for many years in treating various clinical conditions such as thromboembolisms in cardiovascular disease. Some patients require different doses of warfarin to reach the therapeutic international normalized ratio ratio. These patients have specific demographic characteristics. Genetic polymorphisms in specific genes have been reported to be an essential factor in response to warfarin. The present study investigated the effect of these polymorphisms of genes on warfarin dose necessities in pediatric of VCORC1 gene in patients. M

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Brudașcă, Ioana. "Factors influencing vitamin K antagonists therapy / Factori care influențează terapia cu antagoniști ai vitaminei K." Romanian Review of Laboratory Medicine 23, no. 2 (2015). http://dx.doi.org/10.1515/rrlm-2015-0015.

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AbstractVitamin K antagonists (VKAs) are widely used for the primary and secondary prevention of thromboembolism, their anticoagulant effect being monitored through INR. Achieving and maintaining a stable anticoagulation status is challenging, because of the narrow therapeutic range, and of the extremely variable individual response to therapy.Environmental factors such as age, gender, body mass, diet, herbal supplements, drugs, pre-existing pathology, as well as genetic factors can substantially influence the anticoagulant effect of VKAs. The main genetic factors that contribute to individual

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M., Ashmi Sabana, and Alwin Simon M. "Emerging Biomarkers for Assessing Thrombotic Risk in Patients Receiving Direct Oral Anticoagulants (DOACs)." Cardiovascular & Hematological Agents in Medicinal Chemistry 23 (December 16, 2024). https://doi.org/10.2174/0118715257335790241203061748.

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Abstract: Direct Oral Anticoagulants (DOACs) have transformed the management of thrombotic disorders, offering a more convenient and effective alternative to traditional vitamin K antagonists (VKAs). However, assessing thrombotic risk in patients treated with DOACS remains crucial due to the potential for recurrent events. Current clinical risk scores have limitations in predicting and monitoring venous thromboembolism (VTE) risk in specific DOAC populations. Several emerging biomarkers show promise in assessing thrombotic risk in patients treated with DOACS. Genetic factors like VKORC1 and CY

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