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Genotype-guided warfarin dosing may benefit patients with mechanical aortic valve replacements: randomized controlled study
This prospective, single-blind, randomized study was designed to evaluate the effect of genotype-based warfarin dosing compared with standard warfarin dosing in Korean patients with mechanical cardiac valves. Patients were assigned to either the genotype-based dosing group or the standard dosing gro...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181853/ https://www.ncbi.nlm.nih.gov/pubmed/32332930 http://dx.doi.org/10.1038/s41598-020-63985-7 |
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author | Lee, Kyung Eun Yee, Jeong Lee, Gwan Yung Chung, Jee Eun Seong, Jong Mi Chang, Byung Chul Gwak, Hye Sun |
author_facet | Lee, Kyung Eun Yee, Jeong Lee, Gwan Yung Chung, Jee Eun Seong, Jong Mi Chang, Byung Chul Gwak, Hye Sun |
author_sort | Lee, Kyung Eun |
collection | PubMed |
description | This prospective, single-blind, randomized study was designed to evaluate the effect of genotype-based warfarin dosing compared with standard warfarin dosing in Korean patients with mechanical cardiac valves. Patients were assigned to either the genotype-based dosing group or the standard dosing group using stratified block randomization. The genotype-based dosing equation was adopted from a previous study which included VKORC1 rs9934438, CYP2C9 rs1057910, CYP4F2 rs2108622, and age. Primary outcomes included the percentage of time in the therapeutic range (pTTR): (i) during the first week following initiation of warfarin therapy, (ii) during hospitalization and (iii) until the first outpatient visit. A total of 91 patients were included in the analysis, 42 treated with genotype-based warfarin dosing and 49 treated with standard warfarin dosing. The genotype frequency differences of the three SNPs included in this study (ie, VKORC1, CYP2C9, CYP4F2), between the genotype-based dosing and standard dosing groups were not different. The genotype-based dosing group trended toward higher pTTR when compared with the standard dosing group, although this difference was not statistically significant. In patients with aortic valve replacement, TTR(Traditional) and TTR(Rosendaal) were significantly higher in the genotype-based dosing group when compared with the standard dosing group during the first week following treatment initiation [ie, 58.5% vs. 38.1% (p = 0.009) and 64.0% vs. 44.6% (p = 0.012), respectively]. Based on the results, the genotype-guided dosing did not offer a significant clinical advantage, but a possible benefit in patients with aortic valve replacement has been suggested. |
format | Online Article Text |
id | pubmed-7181853 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-71818532020-04-29 Genotype-guided warfarin dosing may benefit patients with mechanical aortic valve replacements: randomized controlled study Lee, Kyung Eun Yee, Jeong Lee, Gwan Yung Chung, Jee Eun Seong, Jong Mi Chang, Byung Chul Gwak, Hye Sun Sci Rep Article This prospective, single-blind, randomized study was designed to evaluate the effect of genotype-based warfarin dosing compared with standard warfarin dosing in Korean patients with mechanical cardiac valves. Patients were assigned to either the genotype-based dosing group or the standard dosing group using stratified block randomization. The genotype-based dosing equation was adopted from a previous study which included VKORC1 rs9934438, CYP2C9 rs1057910, CYP4F2 rs2108622, and age. Primary outcomes included the percentage of time in the therapeutic range (pTTR): (i) during the first week following initiation of warfarin therapy, (ii) during hospitalization and (iii) until the first outpatient visit. A total of 91 patients were included in the analysis, 42 treated with genotype-based warfarin dosing and 49 treated with standard warfarin dosing. The genotype frequency differences of the three SNPs included in this study (ie, VKORC1, CYP2C9, CYP4F2), between the genotype-based dosing and standard dosing groups were not different. The genotype-based dosing group trended toward higher pTTR when compared with the standard dosing group, although this difference was not statistically significant. In patients with aortic valve replacement, TTR(Traditional) and TTR(Rosendaal) were significantly higher in the genotype-based dosing group when compared with the standard dosing group during the first week following treatment initiation [ie, 58.5% vs. 38.1% (p = 0.009) and 64.0% vs. 44.6% (p = 0.012), respectively]. Based on the results, the genotype-guided dosing did not offer a significant clinical advantage, but a possible benefit in patients with aortic valve replacement has been suggested. Nature Publishing Group UK 2020-04-24 /pmc/articles/PMC7181853/ /pubmed/32332930 http://dx.doi.org/10.1038/s41598-020-63985-7 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Lee, Kyung Eun Yee, Jeong Lee, Gwan Yung Chung, Jee Eun Seong, Jong Mi Chang, Byung Chul Gwak, Hye Sun Genotype-guided warfarin dosing may benefit patients with mechanical aortic valve replacements: randomized controlled study |
title | Genotype-guided warfarin dosing may benefit patients with mechanical aortic valve replacements: randomized controlled study |
title_full | Genotype-guided warfarin dosing may benefit patients with mechanical aortic valve replacements: randomized controlled study |
title_fullStr | Genotype-guided warfarin dosing may benefit patients with mechanical aortic valve replacements: randomized controlled study |
title_full_unstemmed | Genotype-guided warfarin dosing may benefit patients with mechanical aortic valve replacements: randomized controlled study |
title_short | Genotype-guided warfarin dosing may benefit patients with mechanical aortic valve replacements: randomized controlled study |
title_sort | genotype-guided warfarin dosing may benefit patients with mechanical aortic valve replacements: randomized controlled study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181853/ https://www.ncbi.nlm.nih.gov/pubmed/32332930 http://dx.doi.org/10.1038/s41598-020-63985-7 |
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