Warfarin genotyping reduces hospitalization rates. Results from MM-WES (Medco-Mayo Warfarin Effectiveness Study).
Robert S. Epstein, et al. JACC 2010;55(25):2804-12.
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Editorial comments
Two genes have been shown in past decade to influence warfarin dosing.
One gene, CYP2C9 determines the activity of hepatic isoenzyme cytochrome P450 2C9 that plays a role in converting S-war-farin to its inactive form.
Second gene, VKORC1 - determines the activity of Vit K epoxide reductase that produces the active form of Vit K that is necessary for clotting.
CYP 2C9 & NKORC1 polymorphisms account for > 1/3rd of variations associated with variations in warfarin dosage. Warfarin sensitivity genotyping involves a test that simultaneously tests for allelic variation in both genes.
Genetic testing is not widely adopted due to lack of studies demonstrating the utility of these tests. This is the first national study on this.
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