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 Blood, 14 May 2009, Vol. 113, No. 20, pp. 4977-4979.
Prepublished online as a Blood First Edition Paper on March 6, 2009; DOI 10.1182/blood-2008-09-176222.

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THROMBOSIS AND HEMOSTASIS

Brief Report

Pharmacogenetic relevance of CYP4F2 V433M polymorphism on acenocoumarol therapy

Virginia Pérez-Andreu1, Vanessa Roldán1, Ana Isabel Antón1, Nuria García-Barberá1, Javier Corral1, Vicente Vicente1, and Rocio González-Conejero1

1 University of Murcia, Centro Regional de Hemodonación, Murcia, Spain

VKORC1 and CYP2C9 polymorphisms are used to predict the safe dose of oral anticoagulant therapy. A new variant of CYP4F2 (V433M) has recently been related to the required warfarin dose. We evaluated its influence in earliest response to acenocoumarol in 100 selected men who started anticoagulation (3 mg for 3 consecutive days). V433M genotype exerted a gene dosage-dependent effect on the decrease of factors II, VII, IX, and X in the earliest response to acenocoumarol, with homozygous 433V subjects being the most sensitive. Similarly, after the initiation of therapy, international normalized ratio also experienced a gene dosage-dependent effect (P = .015), and 433V subjects needed 4 mg/week less than 433M carriers to achieve a steady anticoagulation (P = .043). Multivariate linear regression analysis revealed a significant contribution of V433M polymorphism to variability of both early international normalized ratio value (R2 = 0.14) and dose requirements (R2 = 0.19). Our data underline the relevant role of CYP4F2 V433M polymorphism in the pharmacogenetics of coumarin anticoagulants.


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