To study role of clinical variables and VKORC1 polymorphism in determination of stability of INR in neurological patients on acenocoumarol

Oral anticoagulation (OAC) is difficult to maintain in therapeutic range and their efficacy may be influenced by number of clinical and genetic variables. The objective of the study is to evaluate the role of VKORC1 polymorphism and correlate with stability of anticoagulation. It is a hospital based...

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Main Authors: Ashish Kant Dubey, Surendra Kumar, Jayantee Kalita, Usha Kant Misra
Format: Article
Language:English
Published: Science Planet Inc. 2017-10-01
Series:Canadian Journal of Biotechnology
Online Access:https://www.canadianjbiotech.com/CAN_J_BIOTECH/Archives/v1/Special Issue/cjb.2017-a136.pdf
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author Ashish Kant Dubey
Surendra Kumar
Jayantee Kalita
Usha Kant Misra
author_facet Ashish Kant Dubey
Surendra Kumar
Jayantee Kalita
Usha Kant Misra
author_sort Ashish Kant Dubey
collection DOAJ
description Oral anticoagulation (OAC) is difficult to maintain in therapeutic range and their efficacy may be influenced by number of clinical and genetic variables. The objective of the study is to evaluate the role of VKORC1 polymorphism and correlate with stability of anticoagulation. It is a hospital based study. Patients on OAC were included during 2013-2016. The patients received OAC for cardioembolic stroke, cortical venous sinus thrombosis (CVST) and prevention of deep vein thrombosis (DVT). Demographic, clinical and neurological findings were recorded. Stability of OAC was determined by percentage of international normalized ratio (INR) values in therapeutic range (PINR). PINR >65% were defined as stable and <65% was defined unstable. VKORC 1 polymorphism was studied by polymerase chain reaction and was related to daily dose of OAC and stability of INR. 157 patients with median age of 40 years were included. Ninety two patients received OAC for secondary stroke prevention, 62 for CVST and 3 for DVT. Out of 2976 INR reports, 1458 (49%) were in the therapeutic range, 997 (33.1%) were below and 521 (17.5%) above the therapeutic level. Stable INR was obtained in 75 (47.77%) patients only and was improved by drug modification in 3, and dietary adjustment in 12 patients. VKORC1 polymorphism revealed GG in 127 (80.9%), GA in 22 (14%) and AA genotype in 8 (5.1%) patients. Therapeutic range of INR was seen in 49%, below therapeutic range in 31.5% and above in 17.5%. VKORC1 polymorphism was related to mean daily dose of OAC but not to stability of INR.
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spelling doaj.art-758068f46ed541ee88c76377f531d31b2022-12-22T03:50:25ZengScience Planet Inc.Canadian Journal of Biotechnology2560-83042017-10-011Special Issue15015010.24870/cjb.2017-a136To study role of clinical variables and VKORC1 polymorphism in determination of stability of INR in neurological patients on acenocoumarolAshish Kant Dubey0Surendra Kumar1Jayantee Kalita2Usha Kant Misra3Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, INDIADepartment of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, INDIADepartment of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, INDIADepartment of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, INDIAOral anticoagulation (OAC) is difficult to maintain in therapeutic range and their efficacy may be influenced by number of clinical and genetic variables. The objective of the study is to evaluate the role of VKORC1 polymorphism and correlate with stability of anticoagulation. It is a hospital based study. Patients on OAC were included during 2013-2016. The patients received OAC for cardioembolic stroke, cortical venous sinus thrombosis (CVST) and prevention of deep vein thrombosis (DVT). Demographic, clinical and neurological findings were recorded. Stability of OAC was determined by percentage of international normalized ratio (INR) values in therapeutic range (PINR). PINR >65% were defined as stable and <65% was defined unstable. VKORC 1 polymorphism was studied by polymerase chain reaction and was related to daily dose of OAC and stability of INR. 157 patients with median age of 40 years were included. Ninety two patients received OAC for secondary stroke prevention, 62 for CVST and 3 for DVT. Out of 2976 INR reports, 1458 (49%) were in the therapeutic range, 997 (33.1%) were below and 521 (17.5%) above the therapeutic level. Stable INR was obtained in 75 (47.77%) patients only and was improved by drug modification in 3, and dietary adjustment in 12 patients. VKORC1 polymorphism revealed GG in 127 (80.9%), GA in 22 (14%) and AA genotype in 8 (5.1%) patients. Therapeutic range of INR was seen in 49%, below therapeutic range in 31.5% and above in 17.5%. VKORC1 polymorphism was related to mean daily dose of OAC but not to stability of INR.https://www.canadianjbiotech.com/CAN_J_BIOTECH/Archives/v1/Special Issue/cjb.2017-a136.pdf
spellingShingle Ashish Kant Dubey
Surendra Kumar
Jayantee Kalita
Usha Kant Misra
To study role of clinical variables and VKORC1 polymorphism in determination of stability of INR in neurological patients on acenocoumarol
Canadian Journal of Biotechnology
title To study role of clinical variables and VKORC1 polymorphism in determination of stability of INR in neurological patients on acenocoumarol
title_full To study role of clinical variables and VKORC1 polymorphism in determination of stability of INR in neurological patients on acenocoumarol
title_fullStr To study role of clinical variables and VKORC1 polymorphism in determination of stability of INR in neurological patients on acenocoumarol
title_full_unstemmed To study role of clinical variables and VKORC1 polymorphism in determination of stability of INR in neurological patients on acenocoumarol
title_short To study role of clinical variables and VKORC1 polymorphism in determination of stability of INR in neurological patients on acenocoumarol
title_sort to study role of clinical variables and vkorc1 polymorphism in determination of stability of inr in neurological patients on acenocoumarol
url https://www.canadianjbiotech.com/CAN_J_BIOTECH/Archives/v1/Special Issue/cjb.2017-a136.pdf
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