Yıl 2020, Cilt 13 , Sayı 3, Sayfalar 749 - 757 2020-09-18

Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması
Investigation of CYP2C9 gene polymorphism in patients receiving warfarin therapy

Tutku ERARSLAN [1] , İbrahim TÜRKÇÜER [2] , Aylin KÖSELER [3] , Ramazan SABİRLİ [4] , Atakan YILMAZ [5] , Mert ÖZEN [6] , Abuzer KEKEÇ [7] , Fatih ÇİFÇİBAŞI [8]


Amaç: Çalışmanın amacı warfarin tedavisi almakta olup hastanemize başvuran hastalarda, CYP2C9 gen polimorfizmi durumu ile haftalık doz ihtiyacı, INR düzeyleri arasında ilişkiyi incelemektir. Gereç ve Yöntem: Pamukkale Üniversitesi Tıp Fakültesi Acil Servisine başvuran, warfarin tedavisi kullanan, toplam 100 hasta ve 100 kontrol grubu çalışma kapsamına alındı. Bulgular: Warfarin kullanan grupta CYP2C9*1 allel frekansı 148(%74), CYP2C9*2 allel frekansı 17(%8,5), CYP2C9*3 allel frekansı 35(%17,5), CYP2C9*1/1 genotip frekansı 54 (%54), CYP2C9*1/2 genotip frekansı 11(%11), CYP2C9*1/3 genotip frekansı 29 (%29), CYP2C9*2/3 genotip frekansı 6(%6) olarak saptandı. Warfarin grubunun CYP2C9 genotiplerine ve allellere göre acil servis başvurusundaki INR düzeylerine bakıldığında genotipler veya alleller arasında INR düzeyi açısından istatistiksel anlamlı farklılık saptanmadı (Sırasıyla p=0,475 ve p=0,483). Warfarin kullanılmaya başlandıktan sonra ilk kontrolde yapılan INR ölçümlerinde wild tip genotipe veya allele sahip bireylerde INR düzeyi diğer genotip ve allellere sahip bireylere göre belirgin olarak daha düşük saptandı (Sırasıyla p=0,038 ve p=0,032). Warfarin tedavisi sırasında ölçülen pik INR değeri de aynı şekilde wild tip bireylerde diğer genotip veya allellere sahip bireylere göre daha düşük saptandı (Sırasıyla p=0,0001 ve p=0,008). Sonuç: CYP2C9 geninin mutant allel veya genotiplerini taşıyan hastaların ilk ve pik INR değerlerinin mutasyonsuz olan gruba göre yüksek saptanmış olması bu allellerin warfarin metabolizmasına etkisini ortaya koymaktadır.
Purpose: The aim of the study is to investigate the relationship between CYP2C9 gene polymorphism status and weekly dose requirement and INR levels in patients who are receiving warfarin treatment and admitted to our hospital. Materials and Methods: A total of 100 patients and 100 control groups who applied to the Emergency Department of Pamukkale University Medical Faculty, who used warfarin treatment were included in the study. Results: CYP2C9*1 allele frequency 148 (74%), CYP2C9*2 allele frequency 17 (8.5%), CYP2C9*3 allele frequency 35 (17.5%), CYP2C9*1/1 genotype frequency 54 (%54), CYP2C9*1/2 genotype frequency 11 (11%), CYP2C9*1/3 genotype frequency 29 (29%), CYP2C9*2/3 genotype frequency 6 (6%) were found in the group using warfarin. When the warfarin group was measured according to CYP2C9 genotypes and alleles, there was no statistically significant difference between the genotypes or alleles in terms of INR levels (p=0.475 and p=0.483, respectively). In the INR measurements performed in the first control after the use of warfarin, the INR level was found to be significantly lower in individuals with wild type genotype or allele compared to individuals with other genotypes and alleles (p=0.038 and p=0.032 respectively). The peak INR value measured during warfarin treatment was likewise lower in wild-type individuals than in individuals with other genotypes or alleles (p=0.0001 and p=0.008, respectively). Conclusion: The fact that the first and peak INR values of patients carrying the mutant allele or genotypes of the CYP2C9 gene were higher than the non-mutated group reveals the effect of these alleles on warfarin metabolism.
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Birincil Dil tr
Konular Acil Tıp
Yayınlanma Tarihi Eylül 2020
Bölüm Araştırma Makalesi
Yazarlar

Orcid: 0000-0002-1903-5153
Yazar: Tutku ERARSLAN
Kurum: BİTLİS DEVLET HASTANESİ
Ülke: Turkey


Orcid: 0000-0001-8342-4615
Yazar: İbrahim TÜRKÇÜER (Sorumlu Yazar)
Kurum: PAMUKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0003-4832-0436
Yazar: Aylin KÖSELER
Kurum: PAMUKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0003-4599-5833
Yazar: Ramazan SABİRLİ
Kurum: KAFKAS ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0002-9773-5681
Yazar: Atakan YILMAZ
Kurum: PAMUKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0001-6653-3756
Yazar: Mert ÖZEN
Kurum: PAMUKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0003-0193-4721
Yazar: Abuzer KEKEÇ
Kurum: TUNCELİ DEVLET HASTANESİ
Ülke: Turkey


Orcid: 0000-0003-0049-1682
Yazar: Fatih ÇİFÇİBAŞI
Kurum: BİTLİS TATVAN DEVLET HASTANESİ
Ülke: Turkey


Destekleyen Kurum Pamukkale Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi
Proje Numarası 2016TIPF005
Tarihler

Yayımlanma Tarihi : 18 Eylül 2020

Bibtex @araştırma makalesi { patd743452, journal = {Pamukkale Tıp Dergisi}, issn = {}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2020}, volume = {13}, pages = {749 - 757}, doi = {10.31362/patd.743452}, title = {Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması}, key = {cite}, author = {Erarslan, Tutku and Türkçüer, İbrahim and Köseler, Aylin and Sabi̇rli̇, Ramazan and Yılmaz, Atakan and Özen, Mert and Kekeç, Abuzer and Çi̇fçi̇başı, Fatih} }
APA Erarslan, T , Türkçüer, İ , Köseler, A , Sabi̇rli̇, R , Yılmaz, A , Özen, M , Kekeç, A , Çi̇fçi̇başı, F . (2020). Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması . Pamukkale Tıp Dergisi , 13 (3) , 749-757 . DOI: 10.31362/patd.743452
MLA Erarslan, T , Türkçüer, İ , Köseler, A , Sabi̇rli̇, R , Yılmaz, A , Özen, M , Kekeç, A , Çi̇fçi̇başı, F . "Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması" . Pamukkale Tıp Dergisi 13 (2020 ): 749-757 <https://dergipark.org.tr/tr/pub/patd/issue/55097/743452>
Chicago Erarslan, T , Türkçüer, İ , Köseler, A , Sabi̇rli̇, R , Yılmaz, A , Özen, M , Kekeç, A , Çi̇fçi̇başı, F . "Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması". Pamukkale Tıp Dergisi 13 (2020 ): 749-757
RIS TY - JOUR T1 - Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması AU - Tutku Erarslan , İbrahim Türkçüer , Aylin Köseler , Ramazan Sabi̇rli̇ , Atakan Yılmaz , Mert Özen , Abuzer Kekeç , Fatih Çi̇fçi̇başı Y1 - 2020 PY - 2020 N1 - doi: 10.31362/patd.743452 DO - 10.31362/patd.743452 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 749 EP - 757 VL - 13 IS - 3 SN - -1308-0865 M3 - doi: 10.31362/patd.743452 UR - https://doi.org/10.31362/patd.743452 Y2 - 2020 ER -
EndNote %0 Pamukkale Tıp Dergisi Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması %A Tutku Erarslan , İbrahim Türkçüer , Aylin Köseler , Ramazan Sabi̇rli̇ , Atakan Yılmaz , Mert Özen , Abuzer Kekeç , Fatih Çi̇fçi̇başı %T Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması %D 2020 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 13 %N 3 %R doi: 10.31362/patd.743452 %U 10.31362/patd.743452
ISNAD Erarslan, Tutku , Türkçüer, İbrahim , Köseler, Aylin , Sabi̇rli̇, Ramazan , Yılmaz, Atakan , Özen, Mert , Kekeç, Abuzer , Çi̇fçi̇başı, Fatih . "Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması". Pamukkale Tıp Dergisi 13 / 3 (Eylül 2020): 749-757 . https://doi.org/10.31362/patd.743452
AMA Erarslan T , Türkçüer İ , Köseler A , Sabi̇rli̇ R , Yılmaz A , Özen M , Kekeç A , Çi̇fçi̇başı F . Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması. Pamukkale Tıp Dergisi. 2020; 13(3): 749-757.
Vancouver Erarslan T , Türkçüer İ , Köseler A , Sabi̇rli̇ R , Yılmaz A , Özen M , Kekeç A , Çi̇fçi̇başı F . Varfarin tedavisi alan hastalarda CYP2C9 gen polimorfizminin araştırılması. Pamukkale Tıp Dergisi. 2020; 13(3): 749-757.