服用直接作用口服抗凝剂的中国患者中所选择的药物遗传多态性与出血和血栓栓塞风险的相关性

IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Dongxu Wang, Yang An, Xiaoyue Zhou, Huaru Chai, Jiani Huo, Chunrong Li, Minghui Du, Dapeng Dai, Chuanbao Li, Hao Chen
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引用次数: 0

摘要

目的:基因多态性在直接作用口服抗凝剂(DOACs)的血浆浓度变化中起关键作用。在这项研究中,我们旨在探讨基因变异对中国DOACs患者临床结果的影响。方法:回顾性研究纳入720例接受达比加群、利伐沙班或依多沙班治疗的非瓣膜性心房颤动患者。采用Cox回归模型比较关键单核苷酸多态性携带者和非携带者的临床结果。结果:结果显示,CES1 rs2244613 C等位基因显著降低了达比加群治疗患者的出血事件(校正风险比0.33,95%可信区间0.13-0.85,P = 0.021)。携带ABCB1 rs1045642 T等位基因与利伐沙班使用者血栓栓塞风险降低相关(校正风险比0.19,95%可信区间0.07-0.57,P = 0.003)。此外,在依多沙班使用者中,SLCO1B1 rs4149056 C等位基因与出血风险之间存在统计学意义(P = 0.052)。结论:我们的研究表明,CES1 rs2244613和ABCB1 rs1045642等位基因分别与服用达比加群和利伐沙班的中国患者的结局事件相关。研究结果可以帮助预测临床结果,并为服用DOACs的中国患者制定个性化的抗凝治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relevance of selected pharmacogenetic polymorphisms to bleeding and thromboembolic risks in Chinese patients taking direct-acting oral anticoagulants.

Aims: Gene polymorphisms play a critical role in the variability of plasma concentrations of direct-acting oral anticoagulants (DOACs). In this study, we aimed to investigate the effects of genetic variants on the clinical outcomes of Chinese patients treated with DOACs.

Methods: The retrospective study recruited 720 patients with nonvalvular atrial fibrillation who were receiving dabigatran, rivaroxaban or edoxaban. Cox regression models were employed to compare the clinical outcomes between carriers and noncarriers of the key single nucleotide polymorphisms.

Results: Results revealed that the CES1 rs2244613 C allele significantly reduced bleeding events in patients treated with dabigatran (adjusted hazard ratio 0.33, 95% confidence interval 0.13-0.85, P = .021). The carriage of ABCB1 rs1045642 T allele was associated with a lower risk of thromboembolism in rivaroxaban users (adjusted hazard ratio 0.19, 95% confidence interval 0.07-0.57, P = .003). Additionally, a trend toward statistical significance (P = .052) was observed between the SLCO1B1 rs4149056 C allele and bleeding risk among the edoxaban users.

Conclusions: Our study showed that the CES1 rs2244613 and ABCB1 rs1045642 alleles were associated with outcome events in Chinese patients taking dabigatran and rivaroxaban, respectively. The findings could help predict clinical outcomes and develop personalized anticoagulation treatment strategies for Chinese patients taking DOACs.

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来源期刊
CiteScore
6.30
自引率
8.80%
发文量
419
审稿时长
1 months
期刊介绍: Published on behalf of the British Pharmacological Society, the British Journal of Clinical Pharmacology features papers and reports on all aspects of drug action in humans: review articles, mini review articles, original papers, commentaries, editorials and letters. The Journal enjoys a wide readership, bridging the gap between the medical profession, clinical research and the pharmaceutical industry. It also publishes research on new methods, new drugs and new approaches to treatment. The Journal is recognised as one of the leading publications in its field. It is online only, publishes open access research through its OnlineOpen programme and is published monthly.
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