Genotype-phenotype correlations in patients treated with acenocoumarol / Corelaţii genotip-fenotip la pacienţii trataţi cu acenocumarol

Aim: This research aims to establish a genotype-phenotype correlation in patients treated with acenocoumarol and studies the genetic factors (VKORC1 and CYP2C9 polymorphisms) that may influence INR values during initiation of oral anticoagulant therapy with acenocoumarol. Material and methods: We included 131 patients that needed treatment with acenocoumarol, 70 (53.4%) women and 61 (46.6%) men, observed at the 5th Medical Clinic in Cluj-Napoca, between 2009-2011. We studied the influence of age, gender, concomitant medication and of CYP2C9 and VKORC1 genes on the INR value recorded on the third day of treatment and on the difference between this value and the initial INR value at the starting point for the treatment (INRDIF). Results and conclusion: We demonstrated a statistically significant difference for INR3 and INRDIF values in patients with AA genotype and those with GG genotype of the c.-1639G>A polymorphism of the VKORC1 gene. The presence of AA genotype of the c.-1639G>A polymorphism of the VKORC1 gene determined a 15.7-fold increase in the risk that a patient might display supratherapeutic INR after 2 days of treatment with 4 mg of acenocoumarol