Clinical study of CYP2C9 and VKORC1 gene detection in guiding of warfarin medication after cardiac valve replacement

  Objective  To analyze the standard dose and time of warfarin in patients with different CYP2C9 and VKORC1 genotypes after heart valve surgery, so as to analyze the significance of gene detection in guiding warfarin medication in patients after heart valve surgery.

  Methods  A total of 156 patients who underwent heart valve surgery were randomly selected as study objects, and were divided into four groups according to the test results of CYP2C9 and VKORC1 gene: CYP2C9*3AA group (142 cases), CYP2C9*3 AC group (14 cases), VKORC1 GA/GG group (25 cases) and VKORC1 AA group (131 cases). The age, weight, height, operation method, usage of interference drug, actual standard dose and standard time of different groups were compared.

  Results  The dose of warfarin reaching standard in the CYP2C9*3 AC group was significantly lower than that in the CYP2C9*3AA group (P < 0.05), but there was no significant difference in time of reaching standard between the two groups (P>0.05); the standardized dose of warfarin in the VKORC1 GA/GG group was significantly higher than that in the VKORC1 AA group (P < 0.001), but there was no significant difference in time of reaching standard between the two groups (P>0.05).

  Conclusion  Gene detection of CYP2C9 and VKORC1 is of significance in guiding the use of warfarin in patients after heart valve surgery, which is helpful to guide the selection of initial warfarin dose, but has little influence on the time of reaching the standard.