HealthDay News — For elderly patients treated with vitamin K antagonists for venous thromboembolism (VTE), CYP2C9 variants are associated with any clinical event, according to a study published in the Journal of Thrombosis and Haemostasis.
Michael Nagler, MD, from Bern University Hospital in Switzerland, and colleagues examined the correlation between CYP2C9/VKORC1 variants and long-term clinical outcomes among 774 elderly patients treated with vitamin K antagonists for VTE.
Overall, 78% of the patients had a CYP2C9 or VKORC1 variant. The researchers found that 43.2% of patients had any clinical event, 15.4% died, 12.9% and 21.6% had major and non-major bleeding, respectively, and 12.9% had recurrent VTE.
After adjustment there was a correlation for CYP2C9 variants with any clinical event (hazard ratio, 1.34; 95% confidence interval, 1.08 to 1.66), death (hazard ratio, 1.74; 95% confidence interval, 1.19 to 2.52), and clinically relevant non-major bleeding (subhazard ratio, 1.39; 95% confidence interval, 1.02 to 1.89), but not with major bleeding (subhazard ratio, 1.03; 95% confidence interval, 0.69 to 1.55) or recurrent VTE (subhazard ratio, 0.95; 95% confidence interval, 0.62 to 1.44). Slightly lower anticoagulation quality was seen for patients with genetic variants.
“CYP2C9 was associated with long-term overall mortality and non-major bleeding,” the authors write. “While genetic variants were associated with a slightly lower anticoagulation quality, there was no relationship between genetic variants and major bleeding or VTE recurrence.”
Nagler M, Angelillo-Scherrer, Mean M, et al. Long-term outcomes of elderly patients with CYP2C9 and VKORC1 variants treated with vitamin K antagonists [published online August 22, 2017]. J Thromb Haemost. doi: 10.1111/jth.13810