Impact of VKORC1 gene polymorphism on interindividual and interethnic warfarin dosage requirement--a systematic review and meta analysis

Thrombosis Research
Limei YangHuaijun Zhu

Abstract

Warfarin is the most widely used oral anticoagulant. It has been suggested that anticoagulation effect of warfarin is significantly associated with the polymorphism of certain genes, including Cytochrome P450 complex subunit 2C9 (CYP2C9), Vitamin K Epoxide Reductase Complex Subunit 1 (VKORC1), Gamma-Glutamyl Carboxylase (GGCX) and Apolipoprotein E (APOE) etc. The purpose of the present study was to conduct a systemic review and meta-analysis to investigate the relationship between mean daily warfarin dose (MDWD) and VKORC1 single nucleotide polymorphisms (SNPs). Inclusion and exclusion criteria were made, and the studies between 2004 and present were searched. References were examined, and experts were consulted for additional information. Data were extracted. Revman 4.2.10 software was applied to analyze the relationship between MDWD and VKORC1 SNPs. Total 19 studies were included in the meta-analysis. The frequencies of 1173TT and -1639 AA in Asian patients were higher than those in Caucasian and African populations. Patients with VKORC1 1173 CT and 1173 CC required 44% [95% Confidence Interval (CI); 32%, 56%] and 97% [73%, 122%] higher MDWD than 1173 TT carriers, -1639GA and -1639GG carriers required 52% [41%, 64%] and 102% ...Continue Reading

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