Correlation between rs2108622 locus of CYP4F2 gene single nucleotide polymorphism and warfarin dosage in Iranian cardiovascular patients

Document Type: Research article


1 School of Medicine, Shiraz University of medical science, Shiraz, Iran.

2 School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran

3 School of Medicine, Shiraz University of medical science, Shiraz, Iran

4 Namazi hospital, Shiraz University of medical science, Shiraz, Iran


Many cardiovascular diseases may require lifelong anticoagulation therapy. Warfarin is the most prescribed medication in this regard, however, it has serious side effects. Recently the new issue regarding to warfarin dosing is considered in which some single nucleotide polymorphisms (SNPs) affecting cytochrome P450 system can impact on warfarin metabolism and dosing.
230 cardiovascular patients have participated in the study. The INR levels was 1.5 - 3.5 with a mean range of 2.8. The subjects were divided into two case and control groups. The rs2108622 SNP of the CYP4F2 gene and its effect on warfarin dosing in these patients was accessed.
The results of our study showed a correlation between age and warfarin dosage. The overall frequency of the CC and TT allele of rs2108622 was 53.1% and 18.6%. Daily average dose of warfarin in CC, CT and TT variants was 3.5 ± 1.6, 4.5 ± 2.1 and 5.3 ± 2.1 respectively. The daily warfarin dose in patients with CC allele was significantly lower than that for CT or TT. The patients with TT allele required a 1.8 mg/day higher dose of warfarin than that of CC.
While there are many studies regarding to relation of age and warfarin dose, however, there are different results about pharmacogentic status and warfarin dose in different ethnics. Our study demonstrates that polymorphism in the CYP4F2 rs2108622 has a significant impact on the warfarin requirements in Iranian patients. However the cost benefit of such test should be considered, too.


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