1. Multi-site Investigation of Genetic Determinants of Warfarin Dose Variability in Latinos.
- Author
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El Rouby N, Rodrigues Marcatto L, Claudio K, Camargo Tavares L, Steiner H, Botton MR, Lubitz SA, Fallon EN, Yee K, Kaye J, Scott SA, Karnes J, Caleb Junior de Lima Santos P, Duconge J, and Cavallari LH
- Subjects
- Aged, Brazil, Cohort Studies, Cytochrome P-450 CYP2C9 genetics, Cytochrome P-450 CYP2C9 metabolism, Cytochrome P450 Family 4 genetics, Cytochrome P450 Family 4 metabolism, Dose-Response Relationship, Drug, Female, Gene Frequency, Hispanic or Latino statistics & numerical data, Humans, Male, Middle Aged, NAD(P)H Dehydrogenase (Quinone) genetics, NAD(P)H Dehydrogenase (Quinone) metabolism, Pharmacogenomic Testing statistics & numerical data, Pharmacogenomic Variants, United States, Vitamin K Epoxide Reductases genetics, Vitamin K Epoxide Reductases metabolism, Anticoagulants administration & dosage, Biological Variation, Population genetics, Hispanic or Latino genetics, Thromboembolism drug therapy, Warfarin administration & dosage
- Abstract
We conducted a multi-site investigation of genetic determinants of warfarin dose variability in Latinos from the U.S. and Brazil. Patients from four institutions in the United States (n = 411) and Brazil (n = 663) were genotyped for VKORC1 c.-1639G> A, common CYP2C9 variants, CYP4F2*3, and NQO1*2. Multiple regression analysis was used in the U.S. cohort to test the association between warfarin dose and genotype, adjusting for clinical factors, with further testing in an independent cohort of Brazilians. In the U.S. cohort, VKORC1 and CYP2C9 variants were associated with lower warfarin dose (β = -0.29, P < 2.0 × 10
-16 ; β = -0.21, P = 4.7 × 10-7 , respectively) whereas CYP4F2 and NQO1 variants were associated with higher dose (β = 0.10, P = 2 × 10-4 ; β = 0.10, P = 0.01, respectively). Associations with VKORC1 (β = -0.14, P = 2.0 × 10-16 ), CYP2C9 (β = -0.07, P = 5.6 × 10-10 ), and CYP4F2 (β = 0.03, P = 3 × 10-3 ), but not NQO1*2 (β = 0.01, P = 0.30), were replicated in the Brazilians, explaining 43-46% of warfarin dose variability among the cohorts from the U.S. and Brazil, respectively. We identified genetic associations with warfarin dose requirements in the largest cohort of ancestrally diverse, warfarin-treated Latinos from the United States and Brazil to date. We confirmed the association of variants in VKORC1, CYP2C9, and CYP4F2 with warfarin dose in Latinos from the United States and Brazil., (© 2020 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society of Clinical Pharmacology and Therapeutics.)- Published
- 2021
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