Warfarin (Coumarin) anticoagulant therapy optimization -VKORC1 and CYP2C9

Stroke, myocardial infarction and venous thromboembolism are commonly treated and prevented by oral anticoagulants. Vitamin K antagonists (coumarins) are highly effective for that purpose. However, their narrow therapeutic range in combination with a wide variability in dose response poses a considerable risk to patients. Consequences of an inappropriate coumarin dose include life-threatening bleeding (overdose) or lack of therapeutic effect (insufficient dose). Hence, an individualized anticoagulation treatment is of paramount importance for the safety and health of patients.

Coumarin derivatives inhibit the enzyme vitamin K epoxide reductase. Gene variants coding for its subunit 1 (VKORC1) affect the sensitivity to coumarins. Moreover, variants in the metabolizing cytochrome P450 isozyme CYP2C9 influence the coumarin turnover and thus the therapeutic effect of the drug.

Specimen Requirements - 2 ml of peripheral blood collected in an EDTA (lavender top) vacutainer tube.

Transport  - the specimen should be refrigerated (for 1or 2 days) and shipped at room temperature. 

Reporting time - 10-15 days 

Cost – 30 000 AMD (DNA test for 3 polymorphic loci: VKORC1 -2639 G>A, CYP2C9 430 C>T (2C9*2), CYP2C9 1075 A>C (2C9*3). 

For further information please contact:
Tel.: (+374 10) 544367
Fax: (+374 10) 544366
E-mail: infocmg@genetics.sci.am

Price: 30 000 AMD