Clinical Research Details

Descriptive Information
The role of CYP2C9 and VKORC1 genetic polymorphisms on anticoagulation

Nathalie Khoueiry-Zgheib

Completed- Has Results


Conditions and Keywords
Subjects on anticoagulants for various conditions
Anticoagulants, genetic polymorphisms
Study Design
Basic / Translational
Safety and/or Efficacy Study
Observational Study
N/A: Not Applicable
N/A: Not Applicable
N/A: Not Applicable
Eligibility and IRB

In this study, we assessed the impact of CYP2C9*2CYP2C9*3 and/or VKORC1 -1639G>A/1173C>T single nucleotide polymorphisms on oral anticoagulants in a cohort of 231 Lebanese subjects who were on long-term warfarin or acenocoumarol maintenance therapy with International Normalized Ratio (INR) monitored at the American University of Beirut Medical Center. We showed that both CYP2C9 and VKORC1 polymorphisms are common in the Lebanese and influence warfarin and acenocoumarol dose requirements, with CYP2C9*2 polymorphism having a lesser effect on acenocoumarol. 

Manuscript 1: Esmerian MO, Mitri Z, Habbal MZ, Geryess E, Zaatari G, Alam S, Skouri HN, Mahfouz RA, Taher A, Zgheib NK. Influence of CYP2C9 and VKORC1 polymorphisms on warfarin and acenocoumarol in a sample of Lebanese people. J Clin Pharmacol. 2011 Oct;51(10):1418-28 (PMID: 21148049).

Manuscript 2: Isma'eel HA, Sakr GE, Habib RH, Almedawar MM, Zgheib NK, Elhajj IH. Improved accuracy of anticoagulant dose prediction using a pharmacogenetic and artificial neural network-based method. Eur J Clin Pharmacol. 2014 Mar;70(3):265-73 (PMID: 24297344).

Lebanese subjects taking either warfarin (CoumadinĀ®) or acenocoumarol (SintromĀ®) who had INR values determined at the American University of Beirut Medical Center (AUBMC) between 2008 and 2009.

Referral for INR testing at the AUBMC lab.

Age above 18 years, therapy for at least 2 months, same weekly dose of oral anticoagulant over the past 3 INR examinations (maintenance therapy), and clinical follow up by AUBMC physicians. 

Refusal of consent.