Case report on Pharmacogenetic guided warfarin dosing in a postoperative valve replacement patient
Department of Cardiothoracic Surgery, Apollo Hospitals, Greams Road, Chennai, India.
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2024, 18(01), 247–249.
Article DOI: 10.30574/wjbphs.2024.18.1.0211
Publication history:
Received on 05 March 2024; revised on 13 April 2024; accepted on 16 April 2024
Abstract:
Patient underwent mitral valve replacement with mechanical valve and was initiated on oral anticoagulation with standard dose of warfarin. She developed supra therapeutic INR levels. Genotyping of CYP2C9 and VKORC1 encoding genes revealed homozygous variation of CYP2C9*3*3 and heterozygous variation of VKORC1 G>A making her hypersensitive to warfarin. Based on this study result and Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline, a low dose of warfarin (0.5mg per day) was prescribed, to achieve a therapeutic INR of 2.5 to 3.5 and adverse drug effects were avoided.
Keywords:
Warfarin; Pharmacogenetics; CYP2C9; VKORC1
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