Diltiazem efficacy and CYP2D6 gene polymorphism in patients with atrial fibrillation with rapid ventricular response
Abstract Background Diltiazem stands out as one of the front-line drugs administered in the emergency department to achieve acute rate control in patients suffering from atrial fibrillation with rapid Ventricular Response. One of the cytochrome enzymes involved in the metabolism of diltiazem is cyto...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-06-01
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| Series: | The Egyptian Heart Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43044-023-00375-0 |
| _version_ | 1797801358835843072 |
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| author | Mehmet Uluturk Atakan Yilmaz Murat Seyit Mert Ozen Alten Oskay Aykut Kemanci Medine Unal Hande Senol Aylin Koseler Ibrahim Turkcuer |
| author_facet | Mehmet Uluturk Atakan Yilmaz Murat Seyit Mert Ozen Alten Oskay Aykut Kemanci Medine Unal Hande Senol Aylin Koseler Ibrahim Turkcuer |
| author_sort | Mehmet Uluturk |
| collection | DOAJ |
| description | Abstract Background Diltiazem stands out as one of the front-line drugs administered in the emergency department to achieve acute rate control in patients suffering from atrial fibrillation with rapid Ventricular Response. One of the cytochrome enzymes involved in the metabolism of diltiazem is cytochrome P450 2D6 (CYP2D6). Interindividual differences can act on drug metabolism and thus drug efficacy due to the genetic polymorphism induced by the CYP2D6 enzyme. This study explores the association between the efficacy of diltiazem and the genetic polymorphism of CYP2D6 in patients with atrial fibrillation with rapid ventricular response. Results 87 out of 93 individuals with ventricular rate > 120 beats/min constituted the patient cohort. The patients were administered 0.25 mg/kg diltiazem intravenously. As a second dose, 0.35 mg/kg diltiazem was administered to patients who reportedly did not receive adequate drug efficacy. Heart rate control was considered to be achieved in patients whose heart rate fell below 110 beats/min and did not rise above 110 beats/min for 2 h. CYP2D6 *2, *3, *4 and *10 represent allele variants and *1 represents wild type (wt) allele. Achieving rate control after one or two doses of diltiazem in normal allele (wt/wt) carriers proved significantly higher than wt/*2, wt/*4 and wt/*10 heterozygous variant carriers. No significant difference was noted in wt/*3 heterozygous variant carriers. Conclusion The presence of *2, *4 and *10 alleles was observed to significantly compromise the drug efficacy. *3 allele was found to bear no relation to the effect of diltiazem on achieving rate control. |
| first_indexed | 2024-03-13T04:49:15Z |
| format | Article |
| id | doaj.art-305050987edf459dbc9cdc61d1e10537 |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-03-13T04:49:15Z |
| publishDate | 2023-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-305050987edf459dbc9cdc61d1e105372023-06-18T11:17:40ZengSpringerOpenThe Egyptian Heart Journal2090-911X2023-06-017511810.1186/s43044-023-00375-0Diltiazem efficacy and CYP2D6 gene polymorphism in patients with atrial fibrillation with rapid ventricular responseMehmet Uluturk0Atakan Yilmaz1Murat Seyit2Mert Ozen3Alten Oskay4Aykut Kemanci5Medine Unal6Hande Senol7Aylin Koseler8Ibrahim Turkcuer9Department of Emergency Medicine, Faculty of Medicine, Pamukkale UniversityDepartment of Emergency Medicine, Faculty of Medicine, Pamukkale UniversityDepartment of Emergency Medicine, Faculty of Medicine, Pamukkale UniversityDepartment of Emergency Medicine, Faculty of Medicine, Pamukkale UniversityDepartment of Emergency Medicine, Faculty of Medicine, Pamukkale UniversityDepartment of Emergency Medicine, Faculty of Medicine, Pamukkale UniversityDepartment of Emergency Medicine, Faculty of Medicine, Pamukkale UniversityDepartment of Biostatistics, Faculty of Medicine, Pamukkale UniversityDepartment of Biophysics, Faculty of Medicine, Pamukkale UniversityDepartment of Emergency Medicine, Faculty of Medicine, Pamukkale UniversityAbstract Background Diltiazem stands out as one of the front-line drugs administered in the emergency department to achieve acute rate control in patients suffering from atrial fibrillation with rapid Ventricular Response. One of the cytochrome enzymes involved in the metabolism of diltiazem is cytochrome P450 2D6 (CYP2D6). Interindividual differences can act on drug metabolism and thus drug efficacy due to the genetic polymorphism induced by the CYP2D6 enzyme. This study explores the association between the efficacy of diltiazem and the genetic polymorphism of CYP2D6 in patients with atrial fibrillation with rapid ventricular response. Results 87 out of 93 individuals with ventricular rate > 120 beats/min constituted the patient cohort. The patients were administered 0.25 mg/kg diltiazem intravenously. As a second dose, 0.35 mg/kg diltiazem was administered to patients who reportedly did not receive adequate drug efficacy. Heart rate control was considered to be achieved in patients whose heart rate fell below 110 beats/min and did not rise above 110 beats/min for 2 h. CYP2D6 *2, *3, *4 and *10 represent allele variants and *1 represents wild type (wt) allele. Achieving rate control after one or two doses of diltiazem in normal allele (wt/wt) carriers proved significantly higher than wt/*2, wt/*4 and wt/*10 heterozygous variant carriers. No significant difference was noted in wt/*3 heterozygous variant carriers. Conclusion The presence of *2, *4 and *10 alleles was observed to significantly compromise the drug efficacy. *3 allele was found to bear no relation to the effect of diltiazem on achieving rate control.https://doi.org/10.1186/s43044-023-00375-0AF with RVRCYP2D6DiltiazemGenetic polymorphism |
| spellingShingle | Mehmet Uluturk Atakan Yilmaz Murat Seyit Mert Ozen Alten Oskay Aykut Kemanci Medine Unal Hande Senol Aylin Koseler Ibrahim Turkcuer Diltiazem efficacy and CYP2D6 gene polymorphism in patients with atrial fibrillation with rapid ventricular response The Egyptian Heart Journal AF with RVR CYP2D6 Diltiazem Genetic polymorphism |
| title | Diltiazem efficacy and CYP2D6 gene polymorphism in patients with atrial fibrillation with rapid ventricular response |
| title_full | Diltiazem efficacy and CYP2D6 gene polymorphism in patients with atrial fibrillation with rapid ventricular response |
| title_fullStr | Diltiazem efficacy and CYP2D6 gene polymorphism in patients with atrial fibrillation with rapid ventricular response |
| title_full_unstemmed | Diltiazem efficacy and CYP2D6 gene polymorphism in patients with atrial fibrillation with rapid ventricular response |
| title_short | Diltiazem efficacy and CYP2D6 gene polymorphism in patients with atrial fibrillation with rapid ventricular response |
| title_sort | diltiazem efficacy and cyp2d6 gene polymorphism in patients with atrial fibrillation with rapid ventricular response |
| topic | AF with RVR CYP2D6 Diltiazem Genetic polymorphism |
| url | https://doi.org/10.1186/s43044-023-00375-0 |
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