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Prospective validation of the International Warfarin Pharmacogenetics Consortium algorithm in high-risk elderly people (VIALE study).
Filippelli, Amelia; Signoriello, Simona; Bancone, Ciro; Corbi, Graziamaria; Manzo, Valentina; Iesu, Severino; Politi, Cecilia; Gigantino, Alberto; De Donato, Maria Teresa; Masiello, Paolo; Simeon, Vittorio; Della Corte, Alessandro; Cellurale, Michele; Conti, Valeria; Frigino, Massimo; Ciarambino, Tiziana; Marracino, Marta; Carpenito, Laura; Ferrara, Nicola; De Feo, Marisa; Gallo, Ciro.
Afiliação
  • Filippelli A; Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy.
  • Signoriello S; Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Via San Leonardo 1, 84131, Salerno, Italy.
  • Bancone C; Department of Mental Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Via L. Armanni 5, 80138, Napoli, Italy.
  • Corbi G; Department of Cardiac Surgery, Monaldi Hospital, Via L. Bianchi, 80131, Napoli, Italy.
  • Manzo V; Department of Medicine and Health Sciences "V.Tiberio", University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy.
  • Iesu S; Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy.
  • Politi C; Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Via San Leonardo 1, 84131, Salerno, Italy.
  • Gigantino A; Emergency Cardiac Surgery, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Via San Leonardo 1, 84131, Salerno, Italy.
  • De Donato MT; Department of Medicine and Health Sciences "V.Tiberio", University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy.
  • Masiello P; Cardiac Intensive Care Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Via San Leonardo 1, 84131, Salerno, Italy.
  • Simeon V; General Medicine Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Via San Leonardo 1, 84131, Salerno, Italy.
  • Della Corte A; Emergency Cardiac Surgery, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Via San Leonardo 1, 84131, Salerno, Italy.
  • Cellurale M; Department of Mental Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Via L. Armanni 5, 80138, Napoli, Italy.
  • Conti V; Department of Cardiothoracic Sciences, University of Campania Luigi Vanvitelli c/o Monaldi Hospital, Via L. Bianchi, 80131, Napoli, Italy.
  • Frigino M; Department of Translational Medical Sciences, Federico II University, Via S. Pansini, 5, 80131, Napoli, Italy.
  • Ciarambino T; Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy.
  • Marracino M; Clinical Pharmacology Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Via San Leonardo 1, 84131, Salerno, Italy.
  • Carpenito L; Immunohematology and Transfusion Medicine Service, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy.
  • Ferrara N; Internal Medicine Department, Hospital of Sarno, Via Sarno Striano, 84087, Sarno, SA, Italy.
  • De Feo M; General Medicine Unit, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Via San Leonardo 1, 84131, Salerno, Italy.
  • Gallo C; Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy.
Pharmacogenomics J ; 20(3): 451-461, 2020 06.
Article em En | MEDLINE | ID: mdl-31801992
We assessed the predictive accuracy of the Warfarin Pharmacogenetics Consortium (IWPC) algorithm in a prospective cohort of 376 high-risk elderly patients (≥65 years) who required new treatment with warfarin for either medical (non valvular atrial fibrillation) or surgical conditions (heart valve replacement), had ≥1 comorbid conditions, and regularly used ≥2 other drugs. Follow-up visits were performed according to clinical practice and lasted for a maximum of 1 year. Two hundred and eighty-three (75%) patients achieved a stable maintenance dose. Warfarin maintenance doses were low on average (median 20.3 mg/week, interquartile range, 14.1-27.7 mg/week) and were substantially overestimated by the IWPC algorithm. Overall the percentage of patients whose predicted dose of warfarin was within 20% of the actual stable dose was equal to 37.5%, (95% CI 32.0-43.3%). IWPC algorithm explained only 31% of the actual warfarin dose variability. Modifications of the IWPC algorithm are needed in high-risk elderly people.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Farmacogenética / Varfarina / Algoritmos / Internacionalidade / Anticoagulantes Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Farmacogenética / Varfarina / Algoritmos / Internacionalidade / Anticoagulantes Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Ano de publicação: 2020 Tipo de documento: Article