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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...

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Autores principales: Lee, Kyung Eun, Yee, Jeong, Lee, Gwan Yung, Chung, Jee Eun, Seong, Jong Mi, Chang, Byung Chul, Gwak, Hye Sun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
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.
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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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