POSSIBILITIES OF PHARMACOGENETIC TYPING TO SELECT THE DOSE OF WARFARIN

Abstract

A promising direction in the selection of the optimal dose of warfarin is pharmacogenetic typing, taking into account concomitant pathology and taking of other medications. The aim is to analyze the results of pharmacogenetic typing with the selection of an individual maintenance dose of warfarin in patients with atrial fibrillation, prosthetic heart valves, as well as in those who had a history of deep vein thrombosis or pulmonary embolism. Material and methods. For the period from 2013 to 2021, at the Center for Personalized Medicine of the Clinic of South Ural State Medical University (Chelyabinsk), 159 patients underwent a pharmacogenetic study (genotyping and determination of a combination of gene alleles) with the selection of an individual dose of warfarin. Indications for referral for pharmacogenetic typing were transferred deep vein thrombosis and pulmonary embolism in anamnesis, atrial fibrillation, prosthetics of heart valves. Results and conclusions. Maintenance adjusted doses of warfarin were different for certain genotype variants. The highest average values of an individually selected maintenance dose of warfarin were selected for patients with a polymorphism of the VKORC1 gene with a combination of GG alleles, the minimum average values of an individual selected maintenance dose of warfarin were observed in patients with a polymorphism of the CYP2C9 * 3 gene with a combination of AC alleles and the VKORC1 gene with a combination of AA alleles.