Effect of the CYP4F2 gene on warfarin dose in anticoagulated peruvian patients, 2019-2022

Authors

  • Teodoro J. Oscanoa Seguro Social de Salud, Hospital Nacional Guillermo Almenara Irigoyen, Servicio de Geriatría, Lima - Perú. Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Seguridad de Medicamentos, Lima - Perú. Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Lima - Perú
  • María L. Guevara-Fujita Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Lima - Peru
  • María Y. Muñoz-Paredes Seguro Social de Salud, Hospital de Emergencias Grau, Servicio de Hematología, Lima - Peru
  • Oscar Acosta Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Lima - Peru
  • Ricardo M. Fujita Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Lima - Peru

DOI:

https://doi.org/10.35434/rcmhnaaa.2024.172.2153

Keywords:

Warfarin, Pharmacogenetics, CYP4F2, Anticoagulation, International normalized ratio

Abstract

Introduction: Warfarin is an anticoagulant whose efficacy depends on reaching and maintaining an INR (International Normalized Ratio) within therapeutic ranges. Up to 60% of interindividual dose-response variability can be explained by pharmacogenes, in this regard there are no studies in Peru. We studied the effect of the CYP4F2 gene on the dose of warfarin in Peruvian patients.

Material and Methods: A descriptive and ambispective observational study was carried out with patients seen in the Grau ESSALUD Hospital Hematology Service, Lima, Peru, selected by non-probabilistic convenience sampling. The inclusion criteria were patients anticoagulated for more than three months and with stable doses of warfarin (same dose for at least three outpatient visits and with an INR in therapeutic ranges of 2.5-3.5). Analysis of the CYP4F2 gene was performed by taking a DNA sample from peripheral blood.

Results: 70 patients with a mean age of 69.6 + 13.4, male 38 (54.39%) and female 32 (45.7%) entered the study. The mean dose of warfarin was 31.6 + 15.2 mg/week. The genotypic frequency of the CYP4F2 gene, rs2108622 variant (CT) was 55 (78%), 13 (19%) and 2 (3%) of CC, CT, TT, respectively. No deviation from the Hardy-Weinberg equilibrium was found in the variants studied (p=0.56). Mean warfarin doses/week of the CC, CT, TT genotypes were 30.34 + 11.98; 36.4 + 25.6 and 36.25 + 1.8 mg/week, respectively (p=0.397).

Conclusion: In conclusion, it appears that CYP4F2 gene genotypes do not have a significant effect on warfarin dose.

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Author Biographies

Teodoro J. Oscanoa, Seguro Social de Salud, Hospital Nacional Guillermo Almenara Irigoyen, Servicio de Geriatría, Lima - Perú. Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Seguridad de Medicamentos, Lima - Perú. Universidad Nacional Mayor de San Marcos, Facultad de Medicina, Lima - Perú

1. Medical doctor

2. PhD in medicine

María L. Guevara-Fujita, Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Lima - Peru

1. PhD in Science, mention in Biochemistry and Molecular Biology

María Y. Muñoz-Paredes, Seguro Social de Salud, Hospital de Emergencias Grau, Servicio de Hematología, Lima - Peru

1. Medical Doctor, specialist in Hematology

Oscar Acosta, Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Lima - Peru

1. PhD in Biological Sciences

Ricardo M. Fujita, Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Genética y Biología Molecular, Lima - Peru

1. PhD in Molecular Genetics

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Published

2024-07-03

How to Cite

1.
Oscanoa TJ, Guevara-Fujita ML, Muñoz-Paredes MY, Acosta O, Fujita RM. Effect of the CYP4F2 gene on warfarin dose in anticoagulated peruvian patients, 2019-2022. Rev. Cuerpo Med. HNAAA [Internet]. 2024 Jul. 3 [cited 2024 Nov. 21];17(2). Available from: https://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/2153