Pharmacogenetics of Oral Anticoagulants

Jiménez-Varo, Enrique; Cañadas-Garre, Marisa; Aguilera, Margarita; Callejas, Desiree Gonzalez; Ramírez, Cristina Pérez; Hernández, Miguel Ángel Calleja

doi:10.1007/978-81-322-1184-6_21

Cited by 1 publication

(1 citation statement)

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“…CYP1A1 Cytochrome P450 family 1, subfamily A, polypeptide1; CYP1A2 Cytochrome P450 family 1, subfamily A, polypeptide 2; CYP2C18 Cytochrome P450 family 2, subfamily C, polypeptide 18; CYP2C19 Cytochrome P450 family 2, subfamily C, polypeptide19; CYP3A4 Cytochrome P450 family 3, subfamily A, polypeptide 4; CYP2C9 Cytochrome P450 family 2, subfamily C, polypeptide 9; CYP2C3A5 Cytochrome P450 family 3, subfamily A, polypeptide 5. Adapted after [38,39].…”

Section: Figurementioning

confidence: 99%

Oral Anticoagulant Therapy—When Art Meets Science

Cîmpan¹,

Chira

Mocan

et al. 2019

JCM

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Anticoagulant treatment is extremely important and frequently encountered in the therapy of various cardiovascular diseases. Vitamin K antagonists (VKA) are in use for the prevention and treatment of arterial and venous thromboembolism, despite the introduction of new direct-acting oral anticoagulants (NOAC). The VKA still have the clear recommendation in patients with a mechanical prosthetic heart valve replacement or moderate to severe mitral stenosis of the rheumatic origin, in deep vein thrombosis associated with congenital thrombophilia, and in cases where NOAC are prohibited by social condition (financial reason) or by comorbidities (extreme weight, severe renal or liver disease). VKA dosing required to reach the targeted therapeutic range varies largely between patients (inter-individual variability). This inter-individual variability depends on multiple environmental factors such as age, mass, diet, etc. but it is also influenced by genetic determinism. About 30 genes implicated in the metabolism coumarins derivatives were identified, the most important being CYP2C9 and VKORC, each with several polymorphisms. Herein, we review the data regarding genetic alterations in general and specific populations, highlight the diagnosis options in particular cases presenting with genetic alteration causing higher sensitivity and/or resistance to VKA therapy and underline the utility of NOAC in solving such rare and difficult problems.

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Section: Figurementioning

confidence: 99%