Abstract
Acenocoumarol therapy has been widely used for heart valve replacement (HVR) patients in Vietnam to improve dose management of this drug. The variety of responses among patients to this drug are driven by genetic background. Hence, aim of the study is to explore the relation between acenocoumarol dosages and genetic polymorphisms of CYP2C9*3, VKORC1-1173 C>T and VKORC1-1639 G>A genes. One hundred fifty HVR patients was enrolled in this study. Blood samples were collected and analyzed using PCR and Sanger’s sequencing. The result showed that there was no variant homozygous genotype (CC) of CYP2C9*3 observed, whereas wild-type (AA) and heterozygous (AC) were most abundant with 95.3, and 4.7 %, respectively. In contrast, variant homozygous genotypes of VKORC1-1173 C>T and -1639 G>A accounted for 70.7 and 87.3 % of Vietnamese HVR patient population while wildtype homozygous was not seen. Interestingly, there was significant difference in acenocoumarol doses between 2 genotypes of VKORC1-1173 C>T, but this result was not observed for CYP2C9*3. Patients with the variant homozygous genotype of VKORC1-1173 C>T have the lower dose of acenocoumarol in comparison with heterozygous genotype (p = 0.001). In conclusion, polymorphism of VKORC1-1173 C>T not CYP2C9*3 contributeseemed to relate to acenocoumarol dose responses of Vietnamese HVR patients.
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