Should we test for CYP2C9 before initiating anticoagulant therapy in patients with atrial fibrillation?

ABSTRACT:

Background

Genetic variants of the warfarin sensitivity gene CYP2C9 have been associated with increased bleeding risk during warfarin initiation. Studies also suggest that such patients remain at risk throughout treatment.

Objective

Would testing patients with non-valvular atrial fibrillation (AF) for CYP2C9 before initiating warfarin improve outcomes?

Design

Markov state transition decision model.

Setting

Ambulatory or inpatient settings necessitating new initiation of anticoagulation.

Patients

The base case was a 69-year-old man with newly diagnosed non-valvular AF. Interventions included: (1) warfarin, (2) aspirin, or (3) no antithrombotic therapy without genetic testing; and genetic testing followed by (4) aspirin or (5) no antithrombotic therapy in

SUBMITTER: Eckman MH 

PROVIDER: S-EPMC2669861 | biostudies-literature | 2009 May

REPOSITORIES: biostudies-literature