Guidelines on oral anticoagulation: third edition

“…Because of its narrow therapeutic index, warfarin therapy requires careful monitoring to prevent overanticoagulation, which may lead to dangerous bleeding events, as well as underanticoagulation, which carries the risk of intravascular blood clotting [2]. The international normalized ratio (INR) is used to guide warfarin dosage to reach the correct maintenance dose [3]. Using a recommended INR range to guide warfarin dosage has been shown to be associated with fewer ischemic strokes, less severe strokes, and reduced mortality in patients with atrial fibrillation [4].…”

Section: Introductionmentioning

confidence: 99%

Frequency of CYP2C9 Genotypes among Omani Patients Receiving Warfarin and Its Correlation with Warfarin Dose

Tanira

Al-Mukhaini

Al-Hinai

et al. 2006

Public Health Genomics

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Objectives: This study was conducted to determine the frequency of CYP2C9 alleles in Omani patients receiving warfarin and to correlate genotyping data with warfarin dosage. The Omani population has Asian and African ethnicities. Methods: CYP2C9 genotypes were determined by the polymerase chain reaction restriction fragment length polymorphism method. Non-parametric Kruskal-Wallis test was used to compare groups of continuous data for significance differences. Results: Genotyping data showed that 12.7 and 5.8% of the samples were heterozygous for the CYP2C9*2 and CYP2C9*3 alleles, respectively. The CYP2C9*2 allele frequency was 0.074 in our population. It was 0.029 for CYP2C9*3. Conclusion: This is the first report on the presence of CYP2C9*2 allele homozygocity in any Asian or African population.

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“…Current indications for anticoagulation means more patients require lifelong oral anticoagulant therapy [2][3][4][5]. This has resulted in a cumulative increase in the number of patients seen at the ACC over the years.…”

Section: Introductionmentioning

confidence: 98%

“…A recent systematic review of 67 studies published between 1987 and 2005 showed overall patients were therapeutic 63.6% of the time [10]. The British Society of Haematology (BSH) 1998 Guideline indicates achieving 50% of INRs within 0.5 INR units of the target [2]. In 2005, BSH issued an update on the guideline, recommending that the standard be altered to a standard of time-in-range of 60% within 0.5 INR units of the target [3].…”

Section: Introductionmentioning

confidence: 98%