Authors: Cordula Meyer zu Schwabedissen Vera Mevissen Fabian Schmitz Seth Woodruff Georg Langebartels Thomas Rau Klaus Zerres Rainer Hoffmann Jan R Ortlepp
Publish Date: 2006/07/18
Volume: 62, Issue: 9, Pages: 713-720
Abstract
Two hundred sixty hospital patients started on phenprocoumon were recruited for this study Body mass index BMI waist and hip circumference dietary habits comorbidity and comedication were initially assessed A 5′ exonuclease assay TaqManR was used to analyze the presence of five polymorphisms of the CYP2C9 gene in each of the study patients Study endpoints included the time necessary to achieve the international normalized ratio INR target INR 2 and the total drug amount required to attain target INR For 250 of 260 patients the subsequent required daily maintenance dose of phenprocoumon was also recordedBoth the necessary time and total dose required to attain target INR correlated significantly with BMI The leaner the patient the shorter the required time interval BMI 22 n=31 548±249 days BMI 22–25 n=70 609±240 BMI 25–30 n=113 676±361 BMI 30 n=46 850±575 p=0001 and the lower the required dosage until the therapeutic range was achieved BMI 22 n=31 238±121 mg BMI 22–25 n=70 259±114 mg BMI 25–30 n=113 296±252 BMI 30 n=46 358±197 p=0027 Overweight and waist circumference as a surrogate marker for abdominal fat were also associated significantly with these two parameters Moreover obesity was associated with a lower bodyweightadjusted maintenance dosage All CYP2C9 genotypes that were tested failed to reveal an association with individual response variability
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