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Objective: To study the effect of cytochrome P-4504F2 ( CYP 4 F 2) gene polymorphism on the initial dose of warfarin in patients after mechanical heart valve replacement., Methods: We collected 350 patients receiving warfarin after mechanical heart valve replacement from January 2013 to December 2015 in our hospital. According to the international standardized ratio (INR) ≥2 at the initial stage after surgery, the patients were divided into two groups: INR≥2 group and INR<2 group. We selected the blood samples of all the 350 patients with testing the CYP 4 F 2 gene type of each patient, and analyzed the effect of CYP 4 F 2 gene polymorphism on the initial dose of warfarin after mechanical heart valve replacement (the average daily dose during hospitalization of patients 5-10 days after mechanical heart valve replacement)., Results: There was no statistical significance in the initial dose of warfarin among patients with different CYP 4 F 2 genotypes. However, warfarin dose was higher in CYP 4 F 2 TT genotype than in CYP 4 F 2 CC carriers ((3.37±0.68) mg vs. (2.94±0.74) mg, P <0.05) in INR≥2 group; In patients with the same genotype, the initial dose of warfarin in the CYP 4 F 2 CC ((4.02±0.58) mg vs. (2.94±0.74) mg) and CYP 4 F 2 CT genotypes ((4.15±0.88) mg vs. (3.18±0.82) mg) of INR<2 group was higher than that in INR≥2 group ( P <0.05). Gender, age, body mass index (BMI), comorbidities (hypertension, diabetes mellitus, coronary heart disease, atrial fibrillation), cytopigment P-450 2C9 ( CYP 2 C 9), CYP 4 F 2 and vitamin K peroxide-reductase complex 1 ( VKORC 1) gene polymorphism and INR compliance were included in multiple linear regression analysis. The regression equation was as follows: warfarin initial dose (mg) =-8.634+0.352×BMI (kg/m 2 ) +1.102× CYP 4 F 2 genotype (CC or CT values 1, TT values 2) +2.147× VKORC 1 (AA or AG values 1, GG values 2) +1.325×INR ( INR≥2 values 0, INR<2 values 1). The coefficient of determination ( R 2 ) of regression equation was 0.431 ( P <0.05)., Conclusion: CYP 4 F 2 gene polymorphism may affect the initial dose of warfarin in patients after heart valve replacement, and this effect is also affected by body characteristics and other factors., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)