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Warfarin Sensitivity Testing

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Also known as: Warfarin Sensitivity Genotyping
Formal name: CYP2C9 Genotype; VKORC1 Genotype

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

Chong, K. (2013 November 11, Updated). Warfarin Dosing and VKORC1/CYP2C9. Medscape Drugs and Diseases Available online at http://emedicine.medscape.com/article/1733331-overview through http://emedicine.medscape.com. Accessed 03/21/15.

(2013 November 19). Genetic data does not improve anticoagulation control with warfarin. National Heart Lung and Blood Institute Press Release Available online at http://www.nhlbi.nih.gov/news/press-releases/2013/genetic-data-does-not-improve-anticoagulation-control-with-warfarin through http://www.nhlbi.nih.gov. Accessed 03/21/15.

(2013 November 19). Genetic testing could improve warfarin dosing. American Heart Association Late-Breaking Clinical Trial Report LBCT 5/Abstract: 19658 (Hall E). American Heart Association. Available online at http://newsroom.heart.org/news/genetic-testing-could-improve-warfarin-dosing through http://newsroom.heart.org. Accessed 03/21/15.

Heikal, N. et. al. (2014 June, Updated). Warfarin Sensitivity. ARUP Consult. Available online at http://www.arupconsult.com/Topics/WarfarinSensitivity.html?client_ID=LTD through http://www.arupconsult.com. Accessed 03/21/15.

(2014 May).Warfarin Sensitivity (CYP2C9 and VKORC1) 3 Mutations. ARUP Laboratories. Available online at http://ltd.aruplab.com/Tests/Pdf/197 through http://ltd.aruplab.com. Accessed 03/21/15.

Hamberg, A. and Wadelius, M. (2014). Pharmacogenetics-Based Warfarin Dosing in Children. Medscape News and Perspective from Pharmacogenomics. 2014;15(3):361-374. Available online at http://www.medscape.com/viewarticle/821224 through http://www.medscape.com. Accessed 03/21/15.

Sources Used in Previous Reviews

Linnea M. Baudhuin, Ph.D., DABMG, Assistant Professor of Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.

Shah, S. and Voora, D. (Updated 2010 April 8). Warfarin Dosing and VKORC1/CYP2C9. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/1733331-overview through http://emedicine.medscape.com. Accessed May 2011.

Epstein, R. et. al. (2010 March 30). Warfarin Genotyping Reduces Hospitalization Rates Results From the MM-WES (Medco-Mayo Warfarin Effectiveness Study). J Am Coll Cardiol, 2010; 55:2804-2812 [On-line information]. Available online at http://content.onlinejacc.org/cgi/content/full/j.jacc.2010.03.009v1 through http://content.onlinejacc.org. Accessed May 2011.

Moyer, T. (2009 December). Warfarin Sensitivity Genotyping: A Review of the Literature and Summary of Patient Experience. Mayo Clinic Proceedings v 84 (12) 1079-1094 [On-line information]. Available online at http://www.mayoclinicproceedings.com/content/84/12/1079.full through http://www.mayoclinicproceedings.com. Accessed May 2011.

Mehra, M. (2010 March 16). MM-WES: Genetic testing for warfarin sensitivity linked with reduction in hospitalizations By American College of Cardiology 59th Annual Scientific Sessions. Cardiologytoday [On-line information]. Available online at http://www.cardiologytoday.com/view.aspx?rID=62016 through http://www.cardiologytoday.com. Accessed May 2011.

Bell, J. (2008 October). Experts Debate Pharmacogenetic Testing for Warfarin Sensitivity. Tests Could Enable Better Dosing, But Some Question the Data. AACC 2008 Annual Meeting Highlights, Clinical Laboratory News v 34 (10) [On-line information]. Available online at https://www.aacc.org/publications/cln/2008/october/Pages/am08_highlights1.aspx through https://www.aacc.org. Accessed May 2011.

(© 1995–2011). Mayo Medical Laboratories Unit Code 60529: Warfarin Sensitivity Genotype by Sequence Analysis, Blood [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/60529 through http://www.mayomedicallaboratories.com. Accessed May 2011.

Check, W. (2009 January). PGx tests for warfarin dosing—how soon? CAP Today [On-line information]. Available online through http://www.cap.org. Accessed May 2011.

Karp, J. (2010 March 1). SNP Testing for Warfarin Sensitivity. College of American Pathologists NewsPath [On-line information]. Available online through http://www.cap.org. Accessed May 2011.

Krautscheid, Patti et. al. (Updated 2010 June). Warfarin Sensitivity. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/WarfarinSensitivity.html?client_ID=LTD through http://www.arupconsult.com. Accessed May 2011.

Verhoef; T. et. al. (2010 September 17). Clinical and Economic Consequences of Pharmacogenetic-guided Dosing of Warfarin. Medscape Today from Expert Rev Pharmacoeconomics Outcomes Res. 2010;10(4):375-378. [On-line information]. Available online at http://www.medscape.com/viewarticle/727897 through http://www.medscape.com. Accessed May 2011.

Nainggolan, L. (2009 February 19). Prediction of Initial Dose of Warfarin Aided by Genetic Testing. Medscape News Today from Heartwire [On-line information]. Available online at http://www.medscape.com/viewarticle/588489 through http://www.medscape.com. Accessed May 2011.

(© 1994-2011). Warfarin (Rx) - Coumadin, Jantoven. Medscape Reference [On-line information]. Available online at http://reference.medscape.com/drug/coumadin-jantoven-warfarin-342182 through http://reference.medscape.com. Accessed May 2011.

(Updated 2011 May 13) Frequently Asked Questions About Pharmacogenomics. National Human Genome Research Institute [On-line information]. Available online at http://www.genome.gov/27530645 through http://www.genome.gov. Accessed May 2011.

Carlson, E. (2009 February 25). Web Exclusives: Genetics, Math Gives Blood. National Institute of General Medical Sciences [On-line information]. Available online at http://publications.nigms.nih.gov/computinglife/mathblood.htm through http://publications.nigms.nih.gov. Accessed May 2011.

Osinbawale O, et al. An algorithm for managing warfarin resistance. Cleveland Clinic Journal of Medicine December 2009 vol. 76 12 724-730. Available online at http://www.ccjm.org/content/76/12/724.full through http://www.ccjm.org. Accessed October 2011.

Bussey H, et al. Genetic Testing for Warfarin (Coumadin) Dosing? - Not Yet Ready for Prime Time. July, 2007 from Clot Care Online Resource.  Available online at http://www.clotcare.com/warfaringenetictesting.aspx through http://www.clotcare.com. Accessed October 2011.

Sconce E, et al. The impact of CYP2C9 and VKORC1 genetic polymorphism and patient characteristics upon warfarin dose requirements: proposal for a new dosing regimen. Blood. October 1, 2005 vol. 106 no. 7 2329-2333. Available online at http://bloodjournal.hematologylibrary.org/content/106/7/2329.full through http://bloodjournal.hematologylibrary.org. Accessed October 2011.