Evaluation of the VKORC 1 and CYP2C9 Gene Polymorphisms and Their Effects on the Emergency Complications in the Patients Using Warfarin

Yardim, Oguz; Emektar, Emine; Çevik, Yunsur; Çorbacıoğlu, Şeref Kerem; Karabulut, Ali Ekber

doi:10.5152/eajem.2017.18209

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2019

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“…Because our patient had heterozygous mutation, we cannot explain warfarin resistance via this mechanism. In Turkey, it has been shown that GG mutation had a higher dosage requirement for warfarin compared with the other genotypes (10). On the other hand, in Chinese population, warfarin maintenance doses in AG + GG carriers were higher than those in AA carriers (11).…”

Section: Discussionmentioning

confidence: 97%

Warfarin Resistance: A Case Report

Gönlügür¹,

Gönlügür²,

Özdemir³

et al. 2019

Eurasian J Emerg Med

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Warfarin is the most widely prescribed anticoagulant in the world. Patients who need more than 15 mg per day should be considered warfarin-resistant. Nearly 30 genes have been reported in association with warfarin pharmacogenetics but genetic polymorphisms in the genes encoding CYP2C9 and VKORC1 have been shown to act as the most important determinants of drug dosage requirements. The major enzyme responsible for the metabolism of S-warfarin, the more potent of warfarin's two stereoisomers, is CYP2C9. Warfarin inhibits vitamin K epoxide reductase (VKOR). A 30-year-old woman was referred to our clinic for pulmonary embolism. She was treated with low molecular weight heparin. The warfarin dose was titrated up to 15 mg daily but after one week, the INR (international normalized ratio) was still subtherapeutic level at 1.8. In this paper, we discuss underlying genetic polymorphisms about warfarin resistance.

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Section: Discussionmentioning

confidence: 97%