Genetic Aspects of Warfarin Dosing Algorithms in Cardiac Surgery Patients Who have Undergone Heart Surgery: Systematic Review
Svyatova G. Berezina G. Murtazaliyeva A. Miyerbekov Y. Imammyrzayev U.
2025Georgian Association of Business Press
Georgian Medical News
2025#363Issue 689 - 104 pp.
Objective:To evaluate the clinical outcome, safety, and application of personalized therapy using pharmacogenetic warfarin dosing algorithms in cardiac surgery patients systemically Methods:This systematic review focused on 17 published studies between January 2015 to March 2025 regarding warfarin dosing algorithms incorporating CYP2C9 and VKORC1 polymorphisms in patients who underwent cardiac surgery. The primary outcomes were TTR, BER, and INR stability. The databases search was performed on Scopus, Web of Science, PubMed, and Cochrane. Results:This systematic review highlights the effectiveness of genotype-stratified warfarin dosing after cardiac surgery. Bayesian models showed an improvement in TTR, with NextDose achieving 63% versus 56% with standard dosing. Genotype-guided approaches reduced bleeding events from 34 to 16 and increased INR stability from 83.1% to 86.1%, improving dosing precision and achieving a TTR of 77.76% compared to 57.43%. Conclusion:These findings reinforce the clinical importance of the use of genotype data for more precise warfarin dosing in improving TTR, INR control, and bleeding risk. Further studies are needed to optimize the algorithms, extend the gene panels, and tailor the approaches more for patients after cardiac surgery.
anticoagulation , cardiac surgery , CYP2C9 , dosing algorithm , gene polymorphism , personalized medicine , Pharmacogenetics , VKORC1
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Head of the Scientific and Educational Center, Center for Molecular Medicine, Doctor of Medicine, Professor, Almaty, Kazakhstan
Leading Researcher, Department of Strategy and Science, Joint-Stock Company “Scientific Center of Obstetrics, Gynecology and Perinatology”, Doctor of Biological Sciences, Associate Professor, Almaty, Kazakhstan
Researcher of the Scientific and Educational Center, Center for Molecular Medicine, MSc, Geneticist, Almaty, Kazakhstan
Anaesthesiologist and Intensive Care Specialist, Joint-Stock Company “National Scientific Center of Surgery named after A.N. Syzganov”, Doctor of Medical Sciences, Professor, Almaty, Kazakhstan
Cardiac Surgeon of the First Category, Department of Cardiac Surgery and Heart Transplantation, Joint-Stock Company “National Scientific Center of Surgery named after A.N. Syzganov”, Almaty, Kazakhstan
Head of the Scientific and Educational Center
Leading Researcher
Researcher of the Scientific and Educational Center
Anaesthesiologist and Intensive Care Specialist
Cardiac Surgeon of the First Category
10 лет помогаем публиковать статьи Международный издатель
Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026