Abstract
Aim. To evaluate treatment adherence and prevalence of CYP2C9 and VKORC1 gene mutations in patients with atrial fibrillation (AF) and provide rationale of choice for oral anticoagulation therapy. Material and methods. Treatment adherence was evaluated in 137 AF patients (aged 35-85 years) with quantitative estimation of drug therapy adherence along with compliance to medical support and lifestyle modifications. Among them 82 patients underwent polymerase chain reaction (PCR) analysis of CYP2C9 and VKORC1 gene polymorphisms. Results. Patients receiving anticoagulation therapy are characterized by lower level of adherence compared to patients without anticoagulants (65.2±19.3% vs 68.5±19.1%; Wald-Wolfowitz; p<0.05). Considering all studied parameters men are less adherent than women (54.7±18.6% vs 60.6±16.7%; Kolmogorov-Smirnov; p<0.05). Patients receiving new oral anticoagulants (NOAC) have better compliance compared with patients of warfarin group. Mutations in CYP2C9 gene were detected in 32.9%, VKORC1 – in 68.3%, and their combination – in 21.9% of study participants. Warfarin therapy may be potentially dangerous in such patients due to low adherence. Conclusion. Considering high prevalence of CYP2C9 and VKORC1 gene mutations treatment adherence should be estimated to optimize choice of anticoagulation therapy. NOAC treatment should be considered in patients with low adherence for prevention of thromboembolic complications.
Highlights
82 patients (39 men and 43 women) aged 35-85 years, were randomized into subgroup to evaluate the polymorphism of CYP2C9 and VKORC1 genes with polymerase chain reaction (PCR) analysis
Diagnosed atrial fibrillation (AF) was registered in 4 patients (2.9%), 44 patients had paroxysmal form (32.1%), 47 patients demonstrated persistent form (34.3%) and permanent AF was diagnosed in 42 cases (30.7%)
Patients treated with anticoagulants, demonstrated lower level of adherence to the treatment compared with patients not receiving anticoagulants
Summary
The study included 137 AF patients (68 men and 69 women) aged 35 to 85 years who were hospitalized to Omsk Regional Clinical Cardiology Dispensary and Omsk Municipal Clinical Hospital#2. The study was performed in accordance with medical standard 91500.11.0002-2002. The first stage included quantitative assessment of drug treatment adherence and compliance to medical support and life style modification [8] using a questionnaire consisting of 25 multiple choice questions. The score was summarized and treatment compliance was calculated. 82 patients (39 men and 43 women) aged 35-85 years, were randomized into subgroup to evaluate the polymorphism of CYP2C9 and VKORC1 genes with polymerase chain reaction (PCR) analysis. The study was performed in central research laboratory of Omsk State Medical University
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
