Treatment Adherence as a New Choice Factor for Optimization of Oral Anticoagulation Therapy in Patients with Atrial Fibrillation and Hemostatic Gene Polymorphisms
Aim. To evaluate treatment adherence and prevalence of CYP2C9 and VKORC1 gene mutations in patients with atrial fibrillation (AF) and provide rationale of choice for oral anticoagulation therapy.Material and methods. Treatment adherence was evaluated in 137 AF patients (aged 35-85 years) with quanti...
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| Format: | Article |
| Language: | English |
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Столичная издательская компания
2016-11-01
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| Series: | Рациональная фармакотерапия в кардиологии |
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| Online Access: | https://www.rpcardio.online/jour/article/view/1325 |
| _version_ | 1797232200402337792 |
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| author | Yu. P. Skirdenko A. V. Shustov V. V. Zherebilov N. A. Nikolayev |
| author_facet | Yu. P. Skirdenko A. V. Shustov V. V. Zherebilov N. A. Nikolayev |
| author_sort | Yu. P. Skirdenko |
| collection | DOAJ |
| description | Aim. To evaluate treatment adherence and prevalence of CYP2C9 and VKORC1 gene mutations in patients with atrial fibrillation (AF) and provide rationale of choice for oral anticoagulation therapy.Material and methods. Treatment adherence was evaluated in 137 AF patients (aged 35-85 years) with quantitative estimation of drug therapy adherence along with compliance to medical support and lifestyle modifications. Among them 82 patients underwent polymerase chain reaction (PCR) analysis of CYP2C9 and VKORC1 gene polymorphisms.Results. Patients receiving anticoagulation therapy are characterized by lower level of adherence compared to patients without anticoagulants (65.2±19.3% vs 68.5±19.1%; Wald-Wolfowitz; p<0.05). Considering all studied parameters men are less adherent than women (54.7±18.6% vs 60.6±16.7%; Kolmogorov-Smirnov; p<0.05). Patients receiving new oral anticoagulants (NOAC) have better compliance compared with patients of warfarin group. Mutations in CYP2C9 gene were detected in 32.9%, VKORC1 – in 68.3%, and their combination – in 21.9% of study participants. Warfarin therapy may be potentially dangerous in such patients due to low adherence.Conclusion. Considering high prevalence of CYP2C9 and VKORC1 gene mutations treatment adherence should be estimated to optimize choice of anticoagulation therapy. NOAC treatment should be considered in patients with low adherence for prevention of thromboembolic complications. |
| first_indexed | 2024-03-08T14:02:42Z |
| format | Article |
| id | doaj.art-14c2e69405984602a4acc4bc77d697fe |
| institution | Directory Open Access Journal |
| issn | 1819-6446 2225-3653 |
| language | English |
| last_indexed | 2024-04-24T15:56:30Z |
| publishDate | 2016-11-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj.art-14c2e69405984602a4acc4bc77d697fe2024-04-01T07:43:34ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532016-11-0112549450210.20996/1819-6446-2016-12-5-494-5021253Treatment Adherence as a New Choice Factor for Optimization of Oral Anticoagulation Therapy in Patients with Atrial Fibrillation and Hemostatic Gene PolymorphismsYu. P. Skirdenko0A. V. Shustov1V. V. Zherebilov2N. A. Nikolayev3Omsk State Medical University. Lenina ul. 12, Omsk, 644099 RussiaOmsk Regional Clinical Cardiology Dispensary. Lermontova ul. 41, Omsk, 644024 RussiaOmsk State Medical University. Lenina ul. 12, Omsk, 644099 RussiaOmsk State Medical University. Lenina ul. 12, Omsk, 644099 RussiaAim. To evaluate treatment adherence and prevalence of CYP2C9 and VKORC1 gene mutations in patients with atrial fibrillation (AF) and provide rationale of choice for oral anticoagulation therapy.Material and methods. Treatment adherence was evaluated in 137 AF patients (aged 35-85 years) with quantitative estimation of drug therapy adherence along with compliance to medical support and lifestyle modifications. Among them 82 patients underwent polymerase chain reaction (PCR) analysis of CYP2C9 and VKORC1 gene polymorphisms.Results. Patients receiving anticoagulation therapy are characterized by lower level of adherence compared to patients without anticoagulants (65.2±19.3% vs 68.5±19.1%; Wald-Wolfowitz; p<0.05). Considering all studied parameters men are less adherent than women (54.7±18.6% vs 60.6±16.7%; Kolmogorov-Smirnov; p<0.05). Patients receiving new oral anticoagulants (NOAC) have better compliance compared with patients of warfarin group. Mutations in CYP2C9 gene were detected in 32.9%, VKORC1 – in 68.3%, and their combination – in 21.9% of study participants. Warfarin therapy may be potentially dangerous in such patients due to low adherence.Conclusion. Considering high prevalence of CYP2C9 and VKORC1 gene mutations treatment adherence should be estimated to optimize choice of anticoagulation therapy. NOAC treatment should be considered in patients with low adherence for prevention of thromboembolic complications.https://www.rpcardio.online/jour/article/view/1325warfarinnew oral anticoagulantsadherencecyp2c9vkorc1. |
| spellingShingle | Yu. P. Skirdenko A. V. Shustov V. V. Zherebilov N. A. Nikolayev Treatment Adherence as a New Choice Factor for Optimization of Oral Anticoagulation Therapy in Patients with Atrial Fibrillation and Hemostatic Gene Polymorphisms Рациональная фармакотерапия в кардиологии warfarin new oral anticoagulants adherence cyp2c9 vkorc1. |
| title | Treatment Adherence as a New Choice Factor for Optimization of Oral Anticoagulation Therapy in Patients with Atrial Fibrillation and Hemostatic Gene Polymorphisms |
| title_full | Treatment Adherence as a New Choice Factor for Optimization of Oral Anticoagulation Therapy in Patients with Atrial Fibrillation and Hemostatic Gene Polymorphisms |
| title_fullStr | Treatment Adherence as a New Choice Factor for Optimization of Oral Anticoagulation Therapy in Patients with Atrial Fibrillation and Hemostatic Gene Polymorphisms |
| title_full_unstemmed | Treatment Adherence as a New Choice Factor for Optimization of Oral Anticoagulation Therapy in Patients with Atrial Fibrillation and Hemostatic Gene Polymorphisms |
| title_short | Treatment Adherence as a New Choice Factor for Optimization of Oral Anticoagulation Therapy in Patients with Atrial Fibrillation and Hemostatic Gene Polymorphisms |
| title_sort | treatment adherence as a new choice factor for optimization of oral anticoagulation therapy in patients with atrial fibrillation and hemostatic gene polymorphisms |
| topic | warfarin new oral anticoagulants adherence cyp2c9 vkorc1. |
| url | https://www.rpcardio.online/jour/article/view/1325 |
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