Apolipoprotein E genotype and warfarin dosing among Caucasians and African Americans.

摘要: Warfarin sodium is a vitamin K antagonist that plagued by large variability in patient response, including higher dose requirements among African Americans. Polymorphisms the gene encoding apolipoprotein E (APOE) may partly explain this altering transport of to liver. In prospective cohort study 232 individuals (52.2% Caucasian and 47.8% American) initiating warfarin therapy, weekly maintenance was significantly for Americans than Caucasians (mean 42.9 versus mean 36.9 mg, P=0.018), epsilon4 allele more common (37.8 26.4% Caucasians). multivariable analyses, presence associated with statistically (median 45.0 mg carriers 35.0 non-epsilon4 carriers, P=0.014) but not (38.1 P=0.60). addition, increased according genotype previously differential hepatic chylomicron clearance (epsilon2/epsilon2 or epsilon2/epsilon3: 30.0 mg; epsilon3/epsilon3: epsilon3/epsilon4 epsilon4/epsilon4: P=0.012), although epsilon4/epsilon4 rare clearly doses. The association APOE dosing independent CYP2C9 VKORC1 polymorphisms. polymorphisms thus be important determinants could at least some observed racial differences requirements.