Influence of VKORC1-1639 G > A eene polymorphisms on the bleeding complication risk of warfarin therapy in Chinese patients / 中国药学杂志

ABSTRACT

OBJECTIVE: To conduct a retrospective cohort study and determine the influence of the vitamin K epoxide reductase complex subunit 1 (VKORC1) gene alleles on over anticoagulation and bleeding complication in Chinese population. METHODS: Patients who underwent heart valve replacement operation in Cardiovascular Surgery of Fujian Provincial Hospital between January 2011 and August 2013 were included, who took warfarin at least 3 months and whose INR level was controlled between 1.8 and 2.5. Genotypes of VKORC1-1639 G>A were tested by polymerase chain reaction (PCR)-gene sequencing technique. SPSS19.0 software was used to analyze the association between genotypes andwarfarin bleeding complications, adjusted for demographic and clinical factors. RESULTS Totally 196 patients were included, mean age (50.8 ± 10.7) years, 80 males, average follow-up (26.9 ± 11.8) months. Of the 434 patient-year, 18 severe bleeding and 59 minor bleeding occurred in 31patients. Patients with VKORC1-1639 AA were associated with higher bleeding risk than G carriers (HR 3.14; 95% CI 1.14-8.68). Meanwhile, Kaplan-Meier survival curve showed that time to bleeding evens of VKORC1-1639 AA carriers was shorter than G-carriers(Log-rank test, P=0.03). CONCLUSION: VKORC1-1639 G > A might be the major predictive factor of bleeding complication for warfarin therapy in Chinese patients.