| Author/Editor | Globokar, Tina | |
| Title | Dejavniki, ki vplivajo na antikoagulacijsko zdravljenje z varfarinom pri srčnih bolnikih | |
| Type | monografija | |
| Place | Ljubljana | |
| Publisher | Medicinska fakulteta | |
| Publication year | 2002 | |
| Volume | str. 24 | |
| Language | slo | |
| Abstract | BACKGROUND: The adjustment of the anticoagulant therapy {ACT) with varfarin is strictly individual, its effective dosage varies among the patients up to 100 times. Warfarin belongs to a group of drugs with narrow therapeutic index. It is metabolised by cytochrome P450 2C9 (CYP2C9). AIM: ACT is prescribed to patients with heart diseases in order to prevent systemic embolisms. Anticoagulant effect of warfarin is measured by prothrombin time (PT) and expressed with INR (Internatioal Normalised Ratio). The therapy is effective and safe at INR of therapeutic range. Many factors as comorbid diseases, age and concoxnitant drugs partially explain variation of dosage among the patients receiving warfarin. The finding of polymorphisms CYP2C9 gave us new knowledge about the meaning of genetic factors in ACT with warfarin. Influence of clinical factors and genetic polymorphisms CYP2C9 on dosing, adjusting and complications of ACT has been studied at patients with heart diseases. METHODS: 134 patients (67 female, 67 male, age x =73) years were recruited in the study. Indications for ACT were atrial fibrillation (N=122) and mechanical heart valves (N=12). Data about comorbid diseases, concomitant drugs were collected and body mass index (BMI) was calculated. All patients were in stable periode of ACT. They were receiving warfarin from 6 months to 14 ( x=3,5) years before the inclusion in the study. 36 patients received low doses (<15 mg/week) of warfarin and 98 patients received moderate doses (16-50 mg /week) of warfarin. From medical records we collected patients' data of INR, prescribed weekly warfarin dose and complications of ACT in a period of 6-24 ( x=18,5) months before entering the study. At Institut of biochemistry of Medical faculty genotiping of CYP2C9 was made from genomic DNA isolated from blood cells. (Abstract truncated at 2000 characters). | |
| Descriptors | ATRIAL FIBRILLATION HEART VALVE PROSTHESIS ANTICOAGULANTS THROMBOSIS PROTHROMBIN TIME CYTOCHROME P-450 POLYMORPHISM (GENETICS) GENOTYPE |