Research Article

Establishment of a prediction algorithm for the Honghe minority group based on warfarin maintenance dose

Department of Cardiothoracic Surgery, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

‡Authors contributed equally to this work

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Huan Zhao

Department of Neurology, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Yunli Lou‡

Department of Medical Records & Statistics, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

‡Authors contributed equally to this work

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Jing Wang

Department of Cardiothoracic Surgery, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Sibo Wang

Department of Cardiothoracic Surgery, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Zhongyin Wang

Department of Cardiothoracic Surgery, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Haibo Ou

Department of Cardiothoracic Surgery, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Jun Li

Department of Cardiothoracic Surgery, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Fajian Yang

Clinical Pharmacy Laboratory, Department of Pharmacy, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Lingying Bai

Clinical Pharmacy Laboratory, Department of Pharmacy, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Hong Lv

Clinical Pharmacy Laboratory, Department of Pharmacy, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Xuguan Peng

Department of Cardiothoracic Surgery, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Xiao Chen

Department of Cardiothoracic Surgery, The Yunnan South Central Hospital (The First People's Hospital of Honghe Prefecture), Mengzi, Yunnan, 661100, PR China

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Xiubing Yang‡

*Author for correspondence:

E-mail Address: 75608846@qq.com

Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Bejing, 100029, PR China

‡Authors contributed equally to this work

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Published Online:26 Jul 2022https://doi.org/10.2217/pgs-2022-0038

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Abstract

Background:CYP2C9 and VKORC1 are important factors in warfarin metabolism. The authors explored the effects of these genetic polymorphisms and clinical factors on a warfarin maintenance dose and then established the prediction algorithm for Honghe minorities in China. Materials & methods: Quantitative fluorescence PCR determined the mutation frequency of CYP2C9 and VKORC1-1639 G>A alleles. The authors collected the relevant clinical factors, including age, gender, body surface area (BSA), international normalized ratio value, daily warfarin dose, comorbidity and concomitant prescriptions. Results: The mean values of BSA and international normalized ratio in Honghe minorities were lower than in Han Chinese (p = 0.00). The genotype of CYP2C9*1/*1 and VKORC1-1639 AA was the main allele, the mutationfrequency of VKORC1-1639 AA and the number of male of Honghe minorities were lower than that of Han Chinese (p = 0.013 and p = 0.04). The significances of the effect on actual warfarin dose value were gender, VKORC1 AA mutant, CYP2C9*1/*1, age, hypertension and BSA sequentially. Conclusion: By multiple linear regression analysis with genetic and clinical factors, the authors determined a prediction algorithm for adjusting individual dosing of warfarin in this population. Clinical trial registration number: ChiCTR2100051778.

Tweetable abstract

The combination of CYP2C9*1/*1 and VKORC1-1639 AA was principal genetic determinants of warfarin maintenance doses in Honghe minorities, China. Accordingly, a prediction algorithm was constructed as a reference for adjusting individual dosing of warfarin in this population.

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Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Vol. 23, No. 11

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History

Received 31 March 2022

Accepted 7 July 2022

Published online 26 July 2022

Published in print July 2022

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Keywords

Author contributions

M Qian, X Yang and Y Lou conceived the idea. M Qian and SB Wang secured the funding. J Wang, Z Wang, H Ou and J Li performed the clinical data collection and processing. F Yang, L Bai and H Lv performed the genotyping and analyzed the data. X Peng and X Chen were responsible for follow-up work and collaboration. M Qian wrote the manuscript. Y Lou and H Zhao were responsible for statistical treatment. H Zhao performed the manuscript revision and literature retrieval and utilization. All authors approved the final version.

Financial & competing interests disclosure

The work was supported by the Scientific Research Project of Qingdao University Medical Group, China (grant no. YLJT20201004). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Scientific editing of this manuscript was provided by Medjaden, Inc.

Ethical conduct of research

The authors maintained the experimental standards according to the guidelines and Declaration of Helsinki principles. The Institutional Ethics Committee approved the protocol, which has been signed in the Chinese Clinical Trial Registry (no. ChiCTR2100051778). The experimental study was explained to all the subjects, and signatures were obtained for written informed consent.

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