Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences (RAS ICBFM), Ac, Lavrentiev 8, Novosibirsk, 630090, Russia.
EPMA J. 2012 Sep 27;3(1):10. doi: 10.1186/1878-5085-3-10.
Indirect anticoagulants such as warfarin are the 'gold standard' for prevention and treatment of thromboembolic complications in patients at risk (in atrial fibrillation of valvular and nonvalvular etiology, the presence of artificial heart valves, orthopedic and trauma interventions, and other pathological conditions). A wide range of doses required to achieve a therapeutic effect indicates the need for a personalized approach to the appointment of warfarin. In addition to the dependence on the patient's clinical characteristics (sex, age, smoking status, diagnosis), there is a clear association between the warfarin dose and the carriage of certain allelic variants of key genes that makes it possible to apply molecular genetic testing for individual dose adjustment. This provides a more rapid target anticoagulant effect and also reduces the risk of bleeding associated with a possible overdose of warfarin. Implementation of this approach will allow more wide and safe application of indirect anticoagulants in Russia for needy patients.
间接抗凝剂，如华法林，是预防和治疗有风险的患者（心房颤动的瓣膜和非瓣膜病因、人工心脏瓣膜、骨科和创伤干预以及其他病理状况）血栓栓塞并发症的“金标准”。为了达到治疗效果，需要使用广泛的剂量，这表明需要采用个性化的方法来开华法林。除了依赖于患者的临床特征（性别、年龄、吸烟状况、诊断）外，华法林剂量与关键基因的某些等位基因变异之间存在明确的关联，这使得进行分子遗传检测以进行个体化剂量调整成为可能。这可以更快地达到目标抗凝效果，同时降低因可能过量使用华法林而导致的出血风险。实施这种方法将使间接抗凝剂在俄罗斯更广泛、更安全地应用于有需要的患者。
