The relationship between CYP2C9 gene polymorphisms and upper gastrointestinal bleeding in patients who used warfarin.

作者信息

Ucar Mahmut, Alagozlu Hakan, Sahin Safak, Ozdemir Ozturk

机构信息

1Internal Medicine, Sivas State Hospital, Sivas, 2Department of Internal Medicine, Gastroenterology, School of Medicine, Cumhuriyet University, Sivas, 3School of Medicine, Department of Internal Medicine, Gaziosmanpasa University, Tokat, 4Department of Medical Genetic, School of Medicine, Canakkale Onsekiz Mart University, Canakkale; Turkey.

出版信息

Med Glas (Zenica). 2013 Feb;10(1):50-4.

PMID:23348161

Abstract

AIM

Oral anticoagulants are the most common used substance for treatment and prophylaxis of warfarin venous and arterial thromboembolic disorders in the world. Therapeutic index of warfarin is narrow. CYP2C9 is a hepatic microsomal enzyme and has a primary role in metabolism of warfarin and genetic variations of CYP2C9 may cause a serious effect on the response to warfarin in patients. The aim of this study was to determine the efficiency of CYP2C9 gene polymorphisms on drug metabolism in patients who had upper gastrointestinal system bleeding while using warfarin.

METHODS

There was a total of 67 patients in this study, 37 of whom had upper gastrointestinal system bleeding when INR was above 3 while using warfarin (group 1), 30 of whom had no bleeding and INR was stable under 3 (group 2).

RESULTS

There was no difference in terms of warfarin dose used among the groups (p>0.05). Mutant genotype, INR and aspirin usage were found significantly different in the group with bleeding (p less 0.05). When analyzed in terms of drug interaction, there was no difference between the two groups (p>0.05). Logistic regression analysis was made in order to determine the risk factors that may cause bleeding. Aspirin usage (p= 0.016) and genetic polymorphism (p= 0.024) were related to the increased risk of bleeding.