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dc.contributor.authorCavallari, L.H.
dc.contributor.authorButler, C.
dc.contributor.authorLangaee, T.Y.
dc.contributor.authorWardak, N.
dc.contributor.authorPatel, S.R.
dc.contributor.authorViana, M.A.G.
dc.contributor.authorShapiro, N.L.
dc.contributor.authorNutescu, E.A.
dc.date.accessioned2012-08-21T02:37:57Z
dc.date.available2012-08-21T02:37:57Z
dc.date.issued2011-08
dc.identifier.bibliographicCitationCavallari, L. H., Butler, C., Langaee, T. Y., Wardak, N., Patel, S. R., Viana, M. A. G., Shapiro, N. L., & Nutescu, E. A. 2011. Association of Apolipoprotein E Genotype with Duration of Time to Achieve a Stable Warfarin Dose in African-American Patients. Pharmacotherapy, 31(8): 785-792. DOI: 10.1592/phco.31.8.785en
dc.identifier.issn0277-0008
dc.identifier.otherDOI: 10.1592/phco.31.8.785
dc.identifier.urihttp://hdl.handle.net/10027/8599
dc.description© 2011 by IOS Press, Pharmacotherapy Post print version of article may differ from published version. The definitive version is available through IOS Press at DOI:10.1592/phco.31.8.785en
dc.description.abstractStudy Objective. To test the hypothesis that genotypes for proteins affecting vitamin K availability influence the duration of time required to achieve a stable warfarin dose in African-American patients. Design. Retrospective cohort study Setting. Pharmacist-managed antithrombosis clinic. Patients. Ninety-two African-American adults whose warfarin therapy was initiated between September 2, 1999, and July 8, 2009. Measurements and Main Results, During a routine anticoagulation clinic visit, a sample was collected from each patient for genetic analysis. Genotyping was performed for the following variants: apolipoprotein E epsilon 2, epsilon 3, and epsilon 4; NAD(P)H:quinone oxidoreductase (NQO1)*2; cytochrome P450 (CYP) 4F2 V433M; CYP2C9*2, *3, *5, *8, and *11; and vitamin K epoxide reductase complex 1 (VKORC1) -1639G>A. Patients' medical records were then reviewed, and data were collected retrospectively for each anticoagulation clinic visit during the first 6 months of warfarin therapy or until dose stabilization. The median time required to reach a stable warfarin dose, defined as the dose that produced therapeutic anticoagulation for three consecutive clinic visits, was 83 days. Compared with the 46 patients who achieved a stable warfarin dose within 83 days, the 46 patients who required longer durations for dose stabilization had a higher frequency of the apolipoprotein E epsilon 3/epsilon 3 genotype (37% vs 59%, p=0.037). Sixty-one percent of patients with the epsilon 3/epsilon 3 genotype versus 40% of those with an epsilon 2 or epsilon 4 allele had a delay in achieving a stable dose (p=0.037). Neither the CYP4F2 nor NQO1 genotype was associated with warfarin dose stabilization. Conclusion. Our data support the hypothesis that the apolipoprotein E genotype is associated with duration of time to reach a stable warfarin dose in African-American patients. Further insight into the genetic effects on warfarin dose stabilization could reveal novel methods to improve anticoagulation control during the warfarin initiation period.en
dc.description.sponsorshipThis study was supported by an American Foundation for Pharmaceutical Education New Investigator Award and a University of Illinois Hans Vahlteich Pharmacy Endowment Award to L.H.C.en
dc.language.isoen_USen
dc.publisherIOS Pressen
dc.subjectwarfarinen
dc.subjectgenotypeen
dc.subjectAfrican Americanen
dc.subjectapolipoprotein Een
dc.subjectvitamin Ken
dc.titleAssociation of Apolipoprotein E Genotype with Duration of Time to Achieve a Stable Warfarin Dose in African-American Patientsen
dc.typeArticleen


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