Abstract

Background: Warfarin is a common anticoagulant agent which is widely used in many countries. However, Warfarin is one of those drugs which requires close monitoring and dosing while inappropriate could lead to hemorrhagic epoxides. Achieving a desirable international normalized ratio (INR) range depends on various demographic factors and genetic factors are now becoming an emerging area of interest in cardiovascular research. CYP2C9 is a gene encoding a member of cytochrome P450 enzyme which metabolizes many drugs. Genetic variation in this gene has been linked to abruption in Warfarin drug response. In present study the effect of genetic polymorphisms in CYP2C9 gene and its response to Warfarin is investigated. Methods: Total of 95 patients who had cardiovascular diseases and were using Warfarin for at least 3 months were enrolled in this cross sectional study. Their DNA was extracted and the genetic polymorphisms in CYP2C9 gene (RS1799853 as CYP2C*2 and RS1057910 as CYP2C9*3) were evaluated by using polymerase chain reaction and sequencing. Kruskal-Wallis test were used for comparing the Warfarin values between the genotype groups. The SPSS software 22v was used for data analysis. Results: Among the study population the prevalence of genotypes were as follow: CC/AA: 61.1, CT/AA: 17.9, CT/AC: 1.1, CC/AC: 3.6, TT/AA: 2.3, CC/CC: 0. The CC/AA and CC/AC variants were related to Warfarin dose (P<0.05). These patients require lesser doses of Warfarin in order to achieve the desired INR range. Conclusion: Determination of genetic polymorphisms of effective genes in Warfarin response such as CYP2C9 gene is important in initiating the Warfarin therapy and reducing possible complication of Warfarin. Considering genetic polymorphisms in every population alongside with other effective factors on warfarin dosing should be considered in initiation of anticoagulant therapy. © 2020 EManuscript Technologies. All rights reserved.