Effect of CYP2C9 and VKORC1 genetic polymorphisms on mean daily maintenance dose of acenocoumarol in South Indian patients

Kumar, Dhakchinamoorthi Krishna; Madhan, Sivalingam; Balachander, J.; Chandran, B.V. Sai; Thamijarassy, Bascarne; Chandrasekaran, Adithan

doi:10.1016/j.thromres.2013.02.006

Cited by 13 publications

(1 citation statement)

References 39 publications

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“…When inter-individual dose variability of acenocoumarol in the Indian patients with CYP2C9 and VKORC1 gene polymorphisms were evaluated, lower dose requirements for carriers of the studied polymorphisms had been identified and there was considerable variability in the dose requirements of carriers and non-carriers of the variant alleles [ 137 ]. Similarly, Krishna Kumar D et al, by studying South Indian patients with heart valve replacement, report decreased requirement of the daily maintenance dose of acenocoumarol in patients with CYP2C9 and VKORC1 (- 1639 G > A) genetic polymorphisms [ 138 ]. Although, translation of warfarin pharmacogenetics into clinical practice is slowly emerging in India.…”

Section: Initiation Monitoring and Factors Affecting Anticoagulatiomentioning

confidence: 99%

Follow-up and management of valvular heart disease patients with prosthetic valve: a clinical practice guideline for Indian scenario

Saksena

Mishra

Muralidharan

et al. 2019

Indian J Thorac Cardiovasc Surg

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Purpose Valvular heart disease (VHD) patients after prosthetic valve implantation are at risk of thromboembolic events. Followup care of patients with prosthetic valve has a paramount role in reducing the morbidity and mortality. Currently, in India, there is quintessential need to stream line the follow-up care of prosthetic valve patients. This mandates the development of a consensus guideline for the antithrombotic therapy in VHD patients post prosthetic valve implantation. Methods A national level panel was constituted comprising 13 leading cardio care experts in India who thoroughly reviewed the up to date literature, formulated the recommendations, and developed the consensus document. Later on, extensive discussions were held on this draft and the recommendations in 8 regional meetings involving 79 additional experts from the cardio care in India, to arrive at a consensus. The final consensus document is developed relying on the available evidence and/or majority consensus from all the meetings. Results The panel recommended vitamin K antagonist (VKA) therapy with individualized target international normalized ratio (INR) in VHD patients after prosthetic valve implantation. The panel opined that management of prosthetic valve complications should be personalized on the basis of type of complications. In addition, the panel recommends to distinguish individuals with various co-morbidities and attend them appropriately. Conclusions Anticoagulant therapy with VKA seems to be an effective option post prosthetic valve implantation in VHD patients. However, the role for non-VKA oral therapy in prosthetic valve patients and the safety and efficacy of novel oral anticoagulants in patients with bioprosthetic valve need to be studied extensively.

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Section: Initiation Monitoring and Factors Affecting Anticoagulatiomentioning

confidence: 99%