role of CYP2C9 gene polymorphisms on anticoagulant therapy after heart valve replacement

The aim of the present study was to investigate the role of CYP2C9 gene polymorphisms after heart valve replacement in a group of patients on warfarin therapy. The study population consisted of 74 patients with heart valve replacement. Peripheral blood was collected into evacuated tubes containing EDTA, and DNA was extracted from circulating leukocytes by using a high pure PCR template preparation kit. CYP2C9*2, CYP2C9*3 alleles were detected by using real-time PCR. The patients with CYP2C9*1/*3 and CYP2C9*2/*3 genotypes were taking 28.21 and 24.47 mg, respectively, as mean weekly warfarin dose, whereas patients with CYP2C9*1/*1 genotype were taking 33.90 mg. The data show that patients with CYP2C9*1/*3 and CYP2C9*2/*3 genotypes needed a lower maintenance dose of warfarin than patients with CYP2C9*1/*1 wild-type genotype

Early outcome of concurrent mitral valve replacement and coronary artery bypass grafting

Concomitant coronary artery bypass surgery [CABG] in patients undergoing mitral valve replacement [MVR] has been shown to be an important risk factor for hospital mortality. We evaluated preoperative characteristics, postoperative complications, in-hospital mortality rate, and length of stay in hospital for patients undergoing concurrent CABG with MVR. Preoperative and postoperative clinical data from 175 patients undergoing concurrent CABG with MVR operation at Tehran Heart Center from 2002 through 2006 were collected and entered into a database. Information was obtained by clinical and case note review as well as detailed questionnaires to physicians and patients. Mean age of patients was 57.95 +/- 10.54 years and 51.4% were male. Mean New York Heart Association [NYHA] score was 2.46 +/- 0.84. Among studied patients, 18.3% and 2.9% underwent aortic and tricuspid valve replacement, respectively. In-hospital mortality was 6.9% and 96.0% of patients were hospitalized >/= 14 days. History of congestive heart failure [P = 0.027] and postoperative brain stroke [P = 0.004] were independent predictors for in-hospital mortality. Exact considering of congestive heart failure and postoperative brain stroke related to in-hospital mortality in concurrent CABG with MVR operation are necessary