Meta-Analysis

Impact of CYP2C19 gene polymorphisms on warfarin dose requirement: a systematic review and meta-analysis

Arrhythmia Center, National Center for Cardiovascular Diseases & Fuwai Hospital, CAMS & PUMC, Beijing, 100037, China

Department of Pharmacy Administration & Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China

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Qing Zhang

Department of Cardiovascular, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China

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Hao Chen

*Author for correspondence:

E-mail Address: dr.chenhaomd_bjh@vip.163.com

https://orcid.org/0000-0002-4488-793X

Department of Cardiovascular, Beijing Hospital, National Centre of Gerontology, Beijing, 100730, China

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Published Online:12 Oct 2022https://doi.org/10.2217/pgs-2022-0106

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Abstract

Background: Various genetic factors influence warfarin maintenance dose. Methods: A literature search was performed on PubMed, Embase and the Cochrane Library, and a meta-analysis to analyze the impact of CYP2C19 polymorphisms on warfarin maintenance dose was conducted. Results: From nine studies encompassing 1393 patients, three CYP2C19 SNPs were identified: rs4244285, rs4986893 and rs3814637. Warfarin maintenance dose was significantly reduced by 10% in individuals with the rs4986893 A allele compared with the GG carriers and was 34%, 16% and 18% lower in patients with rs3814637 TT and CT genotypes and T allele, respectively, than that in CC carriers. No significant dose difference was observed among the rs4244285 genotypes. Conclusion:CYP2C19 rs4986893 and rs3814637 are associated with significantly reduced warfarin dose requirements.

Keywords:

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

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Vol. 23, No. 16

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History

Received 31 July 2022

Accepted 12 September 2022

Published online 12 October 2022

Published in print November 2022

Information

Keywords

Author contributions

D Wang and H Chen conceived and designed the study. D Wang and L Yong conducted the literature search, quality assessment and data extraction. D Wang and Q Zhang performed statistical analysis. D Wang drafted the manuscript and L Yong and H Chen critically revised it. H Chen supervised the study.

Financial & competing interests disclosure

This study was funded by National Science Foundation of China (81570307). 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.

Information pertaining to writing assistance

Writing assistance was provided by Elsevier Premium Language Editing Services.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Data sharing statement

Will individual deidentified participant data (including data dictionaries) be shared? Yes.

What data in particular will be shared? Individual participant data that underlie the results reported in this article, after deidentification (text, figures, tables and appendices).

Will additional, related documents be available? Study protocol.

When will the data become available and for how long? Beginning 9 months after and ending 36 months after article publication.

With whom? Investigators whose proposed use of the data has been approved by an independent review committee identified for this purpose.

For what types of analyses? For individual participant data meta-analysis.

What mechanism? Proposals may be submitted up to 36 months after article publication.

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