Abstract:

Objective To evaluate the influence of CYP2C9 and VKORC1 gene polymorphisms on warfarin anticoagulation strategy after cardiac valve replacement. Methods A total of 380 patients undergoing cardiac valve replacement were enrolled randomly,CYP2C9 and VKORC1 gene polymorphisms in 190 cases were detected（gene polymorphism detection group）,and the other 190 cases were used as control group. The warfarin stable dose,the time to reach therapeutic international normalized ratio（INR） and hospitalization time were recorded. Results There were 170 cases of *1*1（89.5%）,19 cases of *1*3（10.0%） and 1 case of *3*3（0.5%） in CYP2C9,and 155 cases（81.6%） had AA,and 35 cases（18.4%） had AG in VKORC1. There was no case with GG. The time to reach therapeutic INR of gene polymorphism detection group [（4.0±1.7）d] was shorter than that of control group [（4.6±2.1）d]（P<0.01）. There was no statistical significance for hospitalization time between the 2 groups（P>0.05）. Conclusions CYP2C9 and VKORC1 gene polymorphism detection plays a role for early clinical anticoagulation strategy,which can shorten the time to reach therapeutic INR and reduce hemorrhage and embolism risk.

Key words: Warfarin, CYP2C9, VKORC1, Gene polymorphism, Cardiac valve replacement