![]() This will allow a more personalized approach to the control of anticoagulant therapy. Recent studies suggest that the pharmacogenetics-guided algorithm may accurately determine warfarin dose and thus reduce adverse events ( 8- 9). They are related to a wide inter-individual and intra-individual variability in a warfarin dosing ( 4- 7). The response to warfarin is also influenced by genetically determined enzymes involved in its metabolism, such as CYP2C9 (cytochrome P (450) 2C9) and VKORC1 (vitamin K epoxide reductase complex subunit 1). Dosing of warfarin may be difficult due to its interaction with commonly used medications and food, which may enhance or reduce its anticoagulation effect ( 3). Reliability of INR monitoring is an important factor influencing the suitability of warfarin therapy in the individual patient. To optimize the therapeutic effect without increasing the risk of bleeding, a close monitoring of prothrombin time, expressed as INR, is required ( 1- 2). Atrial fibrillation (AF) and heart valve disorders represent most frequent indications for life-long thromboprophylaxis with warfarin warfarin is also effective in the treatment and prevention of venous thromboembolism (VTE). Warfarin is a coumarine anticoagulant acting as vitamin K antagonist, interfering with the recycling of vitamin K in the liver leading to reduced production of several clotting factors as well as two coagulation inhibitors protein C and S. Finally, we confirmed a good concordance between the INR determined warfarin doses and pharmacogenetic approach. Statistically significant association between clinically optimized warfarin dose and indication for the treatment, age, and warfarin sensitivity determined by VKORC1, CYP2C9 gene polymorphisms were confirmed. We also analysed the relationship between the dose of warfarin determined by INR and several constitutional and genetic factors. For this purpose, several chemometric tools, namely principal component analysis, cluster analysis, correlation analysis, correspondence analysis, Passing-Bablock regression, Bland-Altman method, descriptive statistics, and ANOVA were used. All patients were tested for gene polymorphisms VKORC1, CYP2C9*C2, and CYP2C9*C3, which were used for a dose calculation employing a program The main goal was to investigate whether the warfarin doses determined by INR are in accordance with the doses calculated according to the pharmacogenetic algorithm. In this study, we investigated 47 patients with effective long-term therapy by warfarin well-controlled by monitoring of International Normalised Ratio (INR). A high prevalence of genetic polymorphisms increases sensitivity to warfarin therapy.
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