PHARMACOKINETIC AND PHARMACODYNAMIC FEATURES OF THE RESPONSE TO WARFARIN THERAPY ON THE EXAMPLE OF EXCESSIVE HYPOCOAGULATION DEVELOPMENT IN A PATIENT OF THE CHUVASH POPULATION WITH A PROSTHETIC HEART VALVE

Abstract

Atrial fibrillation remains a significant public health problem worldwide to this day, and in combination with valvular heart disease it worsens the patient's prognosis. in patients with prosthetic heart valves, the use of anticoagulants is a prerequisite to prevent thromboembolic complications. Indirect anticoagulants, in particular, Warfarin, remain the front-line therapy. This article presents a clinical case of hypersensitivity to Warfarin in a patient of the Chuvash population with an implanted mitral valve. in the postoperative period, difficulties were identified to control the target international normalized ratio. the article examines the factors that could contribute to an increase in sensitivity to Warfarin in this patient. Current literature data on polymorphisms of the CYP2C9 and VKORC1 genes that predetermine hypersensitivity to Warfarin and their prevalence are presented. the clinical case demonstrates the prospects for introducing pharmacogenetic testing as a tool that increases the effectiveness and safety of pharmacotherapy in certain ethnic groups.