The future of warfarin pharmacogenetics in under-represented minority groups

Future Cardiol. 2012 Jul;8(4):563-76. doi: 10.2217/fca.12.31.

Abstract

Genotype-based dosing recommendations are provided in the US FDA-approved warfarin labeling. However, data that informed these recommendations were from predominately Caucasian populations. Studies show that variants contributing to warfarin dose requirements in Caucasians provide similar contributions to dose requirements in US Hispanics, but significantly lesser contributions in African-Americans. Further data demonstrate that variants occurring commonly in individuals of African ancestry, but rarely in other racial groups, significantly influence dose requirements in African-Americans. These data suggest that it is important to consider variants specific for African-Americans when implementing genotype-guided warfarin dosing in this population.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticoagulants / administration & dosage*
  • Anticoagulants / pharmacokinetics*
  • Aryl Hydrocarbon Hydroxylases / genetics*
  • Black or African American / genetics*
  • Calcium-Binding Proteins / genetics
  • Carbon-Carbon Ligases / genetics
  • Cytochrome P-450 CYP2C9
  • Cytochrome P-450 Enzyme System / genetics
  • Cytochrome P450 Family 4
  • Dose-Response Relationship, Drug
  • Genetic Variation
  • Genome-Wide Association Study
  • Genotype
  • Hispanic or Latino / genetics*
  • Humans
  • International Normalized Ratio
  • Minority Groups
  • Mixed Function Oxygenases / genetics
  • Pharmacogenetics
  • Stroke / ethnology
  • Stroke / genetics
  • Vitamin K Epoxide Reductases
  • Warfarin / administration & dosage*
  • Warfarin / pharmacokinetics*
  • White People / genetics

Substances

  • Anticoagulants
  • CALU protein, human
  • Calcium-Binding Proteins
  • Warfarin
  • Cytochrome P-450 Enzyme System
  • Mixed Function Oxygenases
  • CYP2C9 protein, human
  • Cytochrome P-450 CYP2C9
  • Aryl Hydrocarbon Hydroxylases
  • Cytochrome P450 Family 4
  • CYP4F2 protein, human
  • Vitamin K Epoxide Reductases
  • Carbon-Carbon Ligases
  • glutamyl carboxylase