Pharmacogenetic Variants of Warfarin Response Genes in the Kazakh Population: Implications for Personalized Anticoagulant Therapy


Berezina G. Svyatova G. Murtazaliyeva A. Miyerbekov Y. Tuleutayev R.
December 2025Springer International Publishing

Bratislava Medical Journal
2025#126Issue 123728 - 3739 pp.

Genetic variants significantly influence the efficacy and safety of anticoagulants such as warfarin and acenocoumarol, making the study of key polymorphisms in the Kazakh population crucial for personalized medicine. This article aims to determine the frequency of actionable genetic variants in pharmacogenetic genes relevant to warfarin metabolism in Central Asian Kazakhs and to assess their significance for personalized anticoagulant therapy. The study included 1900 conditionally healthy respondents, evenly distributed by sex and age. The analysis focused on the allele frequencies of clinically relevant polymorphisms in the CYP2C9 (*2, *3, *5, *6), CYP2C19 (*1), VKORC1 (*1), CYP4F2 (*1), and GGCX (*1) genes. Notably, the *2 (rs1799853), *3 (rs1057910), *5 (rs28371686), and *6 (rs9332131) polymorphisms of CYP2C9, along with CYP2C19 (rs3814637), VKORC1 (rs9923231), CYP4F2 (rs2108622), and GGCX (rs11676382), were evaluated for their associations with warfarin metabolism and sensitivity. The CYP2C9 variants were present in 16.5% of the population, while the VKORC1 and CYP2C19 variants were found in 28.8% and 30%, respectively. The findings underscore the need for genotyping in this population to optimize warfarin dosing and minimize adverse drug reactions. Further studies will explore the clinical implications of these variants in the context of personalized anticoagulation therapy.

Anticoagulants , Cardiovascular disease , Dose prediction algorithm , Genetic variants , Minor allele frequencies

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Department of Science and Strategic Development, JSC “Scientific Centre for Obstetrics, Gynecology and Perinatology”, Almaty, Kazakhstan
The Republican Medical Genetic Counsultation, JSC “Scientific Centre for Obstetrics, Gynecology and Perinatology”, Almaty, Kazakhstan
Centre for Molecular Medicine, Almaty, Kazakhstan
Department of Continuing Education, JSC “Scientific Centre for Obstetrics, Gynecology and Perinatology”, Almaty, Kazakhstan
Department of Anaesthesiology, Reanimatology and Hyperbaric Oxygenation, National Scientific Center of Surgery named after AN Syzganov, Almaty, Kazakhstan
Department of Cardiac Surgery, Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan

Department of Science and Strategic Development
The Republican Medical Genetic Counsultation
Centre for Molecular Medicine
Department of Continuing Education
Department of Anaesthesiology
Department of Cardiac Surgery

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