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Age and Ageing 2003; 32: 226-227
© 2003, British Geriatrics Society

Case Report

Warfarin sensitivity: be aware of genetic influence

Tayyaba Khan, Farhad Kamali, Ann Daly, Barry King and Hilary A. Wynne1,

Departments of Pharmacological Sciences and
1 Geriatric Medicine, University of Newcastle upon Tyne, Newcastle Upon Tyne NE1 4LP, UK

Background: avoidance of over anticoagulation in response to warfarin therapy would reduce risk of associated bleeding.

Subjects: two elderly patients with venous thromboembolism exhibited extreme anticoagulant response to warfarin. Both were noted to have variant CYP2C9 alleles, which reduce the metabolic capacity of cytochrome P450 2C9.

Discussion: adverse outcomes with warfarin therapy could be explained and possibly avoided by identifying patients with variant alleles for CYP2C9 before initiation of therapy.

Keywords: anticoagulation, warfarin, cytochrome P450 2C9, genetic polymorphism


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