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Verification of Pharmacogenetics-Based Warfarin Dosing Algorithms in Han-Chinese Patients Undertaking Mechanic Heart Valve Replacement

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Listed:
  • Li Zhao
  • Chunxia Chen
  • Bei Li
  • Li Dong
  • Yingqiang Guo
  • Xijun Xiao
  • Eryong Zhang
  • Li Qin

Abstract

Objective: To study the performance of pharmacogenetics-based warfarin dosing algorithms in the initial and the stable warfarin treatment phases in a cohort of Han-Chinese patients undertaking mechanic heart valve replacement. Methods: We searched PubMed, Chinese National Knowledge Infrastructure and Wanfang databases for selecting pharmacogenetics-based warfarin dosing models. Patients with mechanic heart valve replacement were consecutively recruited between March 2012 and July 2012. The predicted warfarin dose of each patient was calculated and compared with the observed initial and stable warfarin doses. The percentage of patients whose predicted dose fell within 20% of their actual therapeutic dose (percentage within 20%), and the mean absolute error (MAE) were utilized to evaluate the predictive accuracy of all the selected algorithms. Results: A total of 8 algorithms including Du, Huang, Miao, Wei, Zhang, Lou, Gage, and International Warfarin Pharmacogenetics Consortium (IWPC) model, were tested in 181 patients. The MAE of the Gage, IWPC and 6 Han-Chinese pharmacogenetics-based warfarin dosing algorithms was less than 0.6 mg/day in accuracy and the percentage within 20% exceeded 45% in all of the selected models in both the initial and the stable treatment stages. When patients were stratified according to the warfarin dose range, all of the equations demonstrated better performance in the ideal-dose range (1.88–4.38 mg/day) than the low-dose range (

Suggested Citation

  • Li Zhao & Chunxia Chen & Bei Li & Li Dong & Yingqiang Guo & Xijun Xiao & Eryong Zhang & Li Qin, 2014. "Verification of Pharmacogenetics-Based Warfarin Dosing Algorithms in Han-Chinese Patients Undertaking Mechanic Heart Valve Replacement," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-8, April.
    • Handle: RePEc:plo:pone00:0094573
    DOI: 10.1371/journal.pone.0094573
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    References listed on IDEAS

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    1. Andrea L Jorgensen & Richard J FitzGerald & James Oyee & Munir Pirmohamed & Paula R Williamson, 2012. "Influence of CYP2C9 and VKORC1 on Patient Response to Warfarin: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-1, August.
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