Document Detail


[Clinical applications of dosing algorithm in the predication of warfarin maintenance dose].
MedLine Citation:
PMID:  22333256     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the feasibility of clinical application for genetic based dosing algorithm in the predication of warfarin maintenance dose in Chinese population.
METHODS: The clinical data were collected and blood samples harvested from a total of 126 patients undergoing heart valve replacement. The genotypes of VKORC1 and CYP2C9 were determined by melting curve analysis after PCR. They were divided randomly into the study and control groups. In the study group, the first three doses of warfarin were prescribed according to the predicted warfarin maintenance dose while warfarin was initiated at 2.5 mg/d in the control group. The warfarin doses were adjusted according to the measured international normalized ratio (INR) values. And all subjects were followed for 50 days after an initiation of warfarin therapy.
RESULTS: At the end of a 50-day follow-up period, the proportions of the patients on a stable dose were 82.4% (42/51) and 62.5% (30/48) for the study and control groups respectively. The mean durations of reaching a stable dose of warfarin were (27.5 ± 1.8) and (34.7 ± 1.8) days and the median durations were (24.0 ± 1.7) and (33.0 ± 4.5) days in the study and control groups respectively. Significant differences existed in the durations of reaching a stable dose between the two groups (P = 0.012). Compared with the control group, the hazard ratio (HR) for the duration of reaching a stable dose was 1.786 in the study group (95%CI 1.088 - 2.875, P = 0.026).
CONCLUSION: The predicted dosing algorithm incorporating genetic and non-genetic factors may shorten the duration of achieving efficiently a stable dose of warfarin. And the present study validates the feasibility of its clinical application.
Authors:
Sheng-Wen Huang; Dao-Kang Xiang; Bang-Quan An; Gui-Fang Li; Ling Huang; Hai-Li Wu
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Zhonghua yi xue za zhi     Volume:  91     ISSN:  0376-2491     ISO Abbreviation:  Zhonghua Yi Xue Za Zhi     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-02-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7511141     Medline TA:  Zhonghua Yi Xue Za Zhi     Country:  China    
Other Details:
Languages:  chi     Pagination:  3421-5     Citation Subset:  IM    
Affiliation:
Department of Laboratory Medicine, Guizhou Provincial People's Hospital, Guiyang 550002, China. Email: hsw713@sina.com.
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