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warfarin ethnic

Leyla Pourgholi, Hamidreza Goodarzynejad, Ali Mandegary, Shayan Ziaee, Azita Hajhosseini Talasaz, Arash Jalali, Mohammadali Boroumand
BACKGROUND: Bleeding episodes commonly occur in patients on warfarin treatment even in those within therapeutic range of international normalized ratio (INR). The objective of this study was to investigate the effects of the 8 examined polymorphisms on the risk of bleeding complications in a sample of Iranian patients. METHODS: A total of 552 warfarin treated patients who maintained on a target INR level of 2.0-3.5 for at least three consecutive intervals were enrolled from those attended our anticoagulation clinics...
October 15, 2016: Toxicology and Applied Pharmacology
K Kubo, M Ohara, M Tachikawa, L H Cavallari, M T M Lee, M S Wen, M G Scordo, E A Nutescu, M A Perera, A Miyajima, N Kaneko, V Pengo, R Padrini, Y T Chen, H Takahashi
Using population pharmacokinetic analysis (PPK), we attempted to identify predictors of S-warfarin clearance (CL(S)) and to clarify population differences in S-warfarin pharmacokinetics among a cohort of 378 African American, Asian and white patients. Significant predictors of CL(S) included clinical (age, body weight and sex) and genotypic (CYP2C9*2,*3 and *8) factors, as well as African American ethnicity, the median CL(S) being 30% lower in the latter than in Asians and whites (170 versus 243 and 250 ml h(-1), P<0...
August 9, 2016: Pharmacogenomics Journal
Aniwaa Owusu Obeng, Tom Kaszemacher, Noura S Abul-Husn, Omri Gottesman, Aida Vega, Eva Waite, Kristin Myers, Judy Cho, Erwin P Bottinger, Stephen B Ellis, Stuart A Scott
Implementation of pharmacogenetic-guided warfarin dosing has been hindered by inconsistent results from reported clinical trials and a lack of available algorithms that include alleles prevalent in non-Caucasian populations. However, current evidence indicates that algorithm-guided dosing is more accurate than empirical dosing. To facilitate multi-ethnic algorithm-guided warfarin dosing using pre-emptive genetic testing, we developed a strategy that accounts for the complexity of race and leverages electronic health records for algorithm variables and deploying point-of-care dose recommendations...
July 9, 2016: Clinical Pharmacology and Therapeutics
Myung Hoon Han, Jae Min Kim, Hyeong-Joong Yi, Jin Hwan Cheong, Yong Ko, Choong Hyun Kim, Young-Soo Kim
BACKGROUND: The volume of intracerebral hemorrhage (ICH) measured at hospital admission is the strongest predictor of clinical outcomes in patients with ICH. Despite the high incidence rate of ICH in Asians, there is lack of data regarding predictors of ICH volume in this ethnic group. The purpose of this study was to determine predictors of deep ICH volume and examine their effect on short-term mortality in Asians. METHODS: Hematoma volume was measured using the ABC/2 method...
June 1, 2016: Cerebrovascular Diseases
Wan-Ying Yu, Xue Sun, Mia Wadelius, Lihua Huang, Chen Peng, Wan-le Ma, Guo-Ping Yang
BACKGROUND: Warfarin is the most extensively used coumarin anticoagulant. It has been shown that the anticoagulant effect of warfarin is associated with genetic variation. Apolipoprotein E (ApoE) is a possible candidate to influence the maintenance dose of warfarin. ApoE affects the vitamin K cycle by mediating the uptake of vitamin K into the liver. The vitamin K cycle is the drug target of warfarin. However, the association between genetic variants of the APOE gene and warfarin dose requirement is still controversial...
October 2016: Cardiovascular Therapeutics
Harsh Golwala, Larry R Jackson, DaJuanicia N Simon, Jonathan P Piccini, Bernard Gersh, Alan S Go, Elaine M Hylek, Peter R Kowey, Kenneth W Mahaffey, Laine Thomas, Gregg C Fonarow, Eric D Peterson, Kevin L Thomas
BACKGROUND: Significant racial/ethnic differences exist in the incidence of atrial fibrillation (AF). However, less is known about racial/ethnic differences in quality of life (QoL), treatment, and outcomes associated with AF. METHODS: Using data from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation, we compared clinical characteristics, QoL, management strategies, and long-term outcomes associated with AF among various racial/ethnic groups...
April 2016: American Heart Journal
Chrong-Reen Wang, Ming-Fei Liu
OBJECTIVES: Although the data from primary antiphospholipid syndrome (APS) suggests a beneficial effect of rituximab usage, its therapeutic role remains to be defined in systemic lupus erythematosus (SLE)-associated APS, a complex clinical situation with thrombotic events and lupus activity. METHODS: A single-center retrospective analysis of rituximab usages in APS was performed in 800 hospitalized SLE patients. RESULTS: There were 63 SLE-associated APS cases with 6 on rituximab therapy, all female aged 37...
August 2016: Seminars in Arthritis and Rheumatism
Rui Liu, Kui Zhang, Zhi-zhong Gong, Xin-miao Shi, Qian Zhang, Xiao-dong Pan, Ran Dong
BACKGROUND: Apolipoprotein E (apoE) induces the uptake of vitamin K-rich lipoproteins by the liver, which likely affects inter-individual variation of warfarin dosing requirements. Associations between APOE polymorphisms and warfarin dosing were previously reported inconsistently among different ethnic groups, so the present study investigated this association in northern Han Chinese patients with mechanical heart valve prosthesis. METHODS: A total of 186 patients who underwent mechanical heart valve replacement and attained a stable warfarin dose were included...
2016: Lipids in Health and Disease
Sarayu Arvind Pai, Nilima Kshirsagar
Our objective was to compare the pharmacogenetic information provided in the package inserts (PIs) of 7 drugs marketed in the United States and India, namely, abacavir, capecitabine, carbamazepine, clopidogrel, irinotecan, valproic acid, and warfarin. We evaluated the pharmacogenetic information provided in Indian PIs for the highest level where it was included, robustness and completeness, clinical validity, and clinical utility and compared it with corresponding data of US PIs. Pharmacogenetic studies carried out in India were identified using PubMed...
October 2016: Journal of Clinical Pharmacology
Haijun Miao, Yu Hong, Keyimu Kabinur, Ting Zou, Abulizi Palida, Xiaohui Zhou
OBJECTIVE: To investigate prevalence of atrial fibrillation (AF) in Uygur and Han elderly populations in Xinjiang Uygur autonomous region (Xinjiang). METHODS: Epidemiological survey was conducted among the residents selected through stratified random cluster sampling in the southern, northern and eastern Xinjiang. RESULTS: The overall AF prevalence among Uygur and Han elderly people was 3.56%. The crude prevalence of AF was 2.91% among Uygur elderly people and 4...
October 2015: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
Mobeen Rahman, Ana Ortega-Lopez, Amy Powers
Herein, we report a case of post-transfusion purpura after the reversal of anticoagulation for surgical purposes in a 66-year old ethnic Asian man who was undergoing long-term warfarin therapy for antiphospholipid syndrome. The patient experienced a sudden decrease in platelet count, from 308,000 per μL from the day of admission to 38,000 per μL the following day. Follow-up testing revealed unremarkable red blood cell (RBC) morphology, no evidence of platelet clumping, and negative heparin-induced antibody test results...
February 2016: Laboratory Medicine
Sujita W Narayan, June M Tordoff, Prasad S Nishtala
BACKGROUND: For older individuals with multimorbidity the appropriateness of prescribing preventive medicines remains a challenge. OBJECTIVE: Investigate the prevalence and temporal trends in utilisation of preventive medicines in older New Zealanders from 2005 to 2013 stratified according to age, sex, ethnicity and district health board domicile. METHODS: A repeated cross-sectional analysis was conducted on pharmaceutical dispensing data for all individuals' ≥ 65 years...
January 2016: Archives of Gerontology and Geriatrics
Celenne Morfin Zepeda, Kristen H Coffey
PATIENT: 66-year-old ethnic Egyptian man. CHIEF COMPLAINT: Hematuria. HISTORY OF PRESENT ILLNESS: The patient had a history of multiple episodes of gross hematuria for the past 5 years. Because the hematuria usually resolved on its own, he did not seek medical attention during that time. Bladder cancer was suspected. PAST MEDICAL HISTORY: The patient had a history of coronary artery disease, hypertension, nephrolithiasis, congestive heart failure, lifelong smoking, and ischemic cardiomyopathy...
2015: Laboratory Medicine
Sze Ling Chan, Nilakshi Samaranayake, Colin J D Ross, Meng Tiak Toh, Bruce Carleton, Michael R Hayden, Yik Ying Teo, Vajira H W Dissanayake, Liam R Brunham
BACKGROUND: Interpopulation differences in drug responses are well documented, and in some cases they correspond to differences in the frequency of associated genetic markers. Understanding the diversity of genetic markers associated with drug response across different global populations is essential to infer population rates of drug response or risk for adverse drug reactions, and to guide implementation of pharmacogenomic testing. Sri Lanka is a culturally and linguistically diverse nation, but little is known about the population genetics of the major Sri Lankan ethnic groups...
January 2016: Pharmacogenetics and Genomics
Ammar Majeed, Samuel Z Goldhaber, Ajay Kakkar, Clive Kearon, Henry Eriksson, Jörg Kreuzer, Martin Feuring, Stephan Hantel, Jeffrey Friedman, Sebastian Schellong, Sam Schulman
Dabigatran was as effective as warfarin for the acute treatment of venous thromboembolism in the RE-COVER and RE-COVER II trials. We compared the incidence of bleeding with dabigatran versus warfarin in pooled data from these studies. The localisation, bleeding severity, and the impact of key factors on the incidence of bleeding, were compared between the dabigatran and warfarin treatment group. Altogether, 2553 patients received dabigatran and 2554 warfarin, each for a mean of 164 days. The incidence of any bleeding event was significantly lower with dabigatran (hazard ratio [HR] 0...
January 2016: Thrombosis and Haemostasis
Qi Peng, Shujun Huang, Xiaoying Chen, Yayan Yuan, Yajun Yu, Liang Tao, Zhenlu Zhang, Mousheng Xu
AIM: To compare the accuracy of the nine selected algorithms for predicting warfarin dose with 586 Han Chinese patients. MATERIALS & METHODS: Genotyping of VKORC1 1639G>A, CYP2C9*2 and CYP2C9*3 variants was performed. Both the mean absolute error and ideal estimation value were used for comparison. RESULTS: The top three performers were from East Asians. The algorithms from Caucasians generally performed better in the medium-dose subgroup (>3 and <7 mg/day), while the algorithms from East Asians generally performed better in the low-dose subgroup (≤ 3 mg/day)...
2015: Pharmacogenomics
Nicholas L X Syn, Soo-Chin Lee, Liam R Brunham, Boon-Cher Goh
BACKGROUND: Clinical trials of genotype-guided dosing of warfarin have yielded mixed results, which may in part reflect ethnic differences among study participants. However, no previous study has compared genotype-guided versus clinically guided or standard-of-care dosing in a Chinese population, whereas those involving African-Americans were underpowered to detect significant differences. We present a preclinical strategy that integrates pharmacogenetics (PG) and pharmacometrics to predict the outcome or guide the design of dosing strategies for drugs that show large interindividual variability...
October 2015: Pharmacogenetics and Genomics
Darren M Triller, Susan Wymer, Patrick D Meek, Elaine M Hylek, Jack E Ansell
Anticoagulation with warfarin requires frequent evaluation of the international normalized ratio (INR), and less invasive testing devices are available for use by clinicians at the point-of-care (POC) and by patients who self-test (PST). Despite commercial availability and positive results of published studies, evidence suggests that adoption of less invasive (POC/PST) testing in the United States is slow. Considering the equivalence of results and logistical advantages of POC/PST testing, slow uptake may indicate a gap in quality of care warranting evaluation and possibly intervention...
October 2015: Journal of Community Health
Csilla Sipeky, Agnes Weber, Bela I Melegh, Petra Matyas, Ingrid Janicsek, Renata Szalai, Istvan Szabo, Reka Varnai, Greta Tarlos, Alma Ganczer, Bela Melegh
AIMS: Pharmacogenetic based dosing recommendations are provided in FDA-approved warfarin label for Caucasians. Evidence of notable difference in dosing algorithms of under-represented populations forced us to explore the genetic variability of CYP4F2 gene in Roma and Hungarian populations. PATIENTS AND METHODS: 484 Roma, 493 Hungarian untreated subjects were genotyped for the CYP4F2*3 (rs2108622) variant by PCR-RFLP assay. RESULTS AND DISCUSSION: We firstly report, that frequencies of the CYP4F2 rs2108622 GG, GA, AA genotypes and A allele in the Roma population were 46...
July 2015: Environmental Toxicology and Pharmacology
Kazuhiro Yamamoto, Hideya Yamamoto, Masaaki Takeuchi, Akira Kisanuki, Takashi Akasaka, Nobuyuki Ohte, Yutaka Hirano, Kiyoshi Yoshida, Satoshi Nakatani, Yasuharu Takeda, Takashi Sozu, Tohru Masuyama
BACKGROUND: Because of ethnic difference in the risk of degenerative aortic valve disease (DAVD), risk factors should be clarified in each race to establish prophylactic strategies for severe aortic valve stenosis (AS). METHODS AND RESULTS: This study prospectively followed 359 Japanese subjects with DAVD and age ≥50 years for 3 years. As both patients with peak aortic transvalvular flow velocity ≥2 m/s and <2 m/s were enrolled, subgroup analysis was also conducted...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
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