Table 3.
Predictive model for logarithm of stable coumarin dose according to patients’ clinical and genetic characteristics
WHITES | ||||||||
---|---|---|---|---|---|---|---|---|
Acenocoumarol | Warfarin | |||||||
Parameter estimate (95% Cl) | P value | R2 test (N = 2,744) | R2 validation (N = 1,410) | Parameter estimate (95% Cl) | P value | R2latest (N = 3,016) | R2 validation (N = 1,532) | |
Intercept | 4.069 (3.883; 4.256) | < 0.0001 | 0.33 | 0.28 | 3.981 (3.887; 4.075) | < 0.0001 | 0.51 | 0.52 |
Agea | −0.014 (−0.015; −0.012) | < 0.0001 | −0.009 (−0.010; −0.008) | < 0.0001 | ||||
BMIa | −0.002 (−0.006; 0.002) | 0.28 | 0.010 (0.008; 0.012) | < 0.0001 | ||||
Male gender | 0.014 (−0.024; 0.052) | 0.47 | 0.123 (0.098; 0.148) | < 0.0001 | ||||
Indication for treatmentb | 0.000 (−0.042; 0.042) | 0.98 | −0.043 (−0.069; −0.017) | 0.001 | ||||
CYP2C9 *2 1-allele | −0.190 (−0.232; −0.147) | < 0.0001 | −0.231 (−0.261; −0.202) | < 0.0001 | ||||
CYP2C9 *2 2-alleles | −0.359 (−0.484; −0.234) | < 0.0001 | −0.513 (−0.600; −0.426) | < 0.0001 | ||||
CYP2C9 *3 1-allele | −0.394 (−0.446; −0.342) | < 0.0001 | −0.387 (−0.425; −0.350) | < 0.0001 | ||||
CYP2C9 *3 2-alleles | −1.214 (−1.522; −0.907) | < 0.0001 | −1.316 (−1.502; −1.131) | < 0.0001 | ||||
VK0RC1 AG | −0.291 (−0.332; −0.249) | < 0.0001 | −0.266 (−0.292; −0.240) | < 0.0001 | ||||
VK0RC1 AA | −0.762 (−0.816; −0.708) | < 0.0001 | −0.666 (−0.704; −0.629) | < 0.0001 | ||||
CYP4F2 CT | 0.018 (−0.022; 0.058) | 0.39 | 0.073 (0.047; 0.098) | < 0.0001 | ||||
CYP4F2 TT | 0.100 (0.041; 0.159) | 0.0009 | 0.191 (0.147; 0.235) | < 0.0001 | ||||
ASIANS | ||||||||
Acenocoumarol | Warfarin | |||||||
Parameter estimate | P value | R2 test (N=0) | R2 validation (N=0) | Parameter estimate | P value | R2 test (N = 292) | R2 validation (N = 146) | |
Intercept | - | - | - | - | 3.484 (3.112; 3.855) | < 0.0001 | 0.45 | 0.42 |
Agea | - | - | -0.005 (−0.008; −0.001) | 0.02 | ||||
BMIa | - | - | 0.014 (0.004; 0.023) | 0.004 | ||||
Male gender | - | - | 0.058 (−0.050; 0.167) | 0.29 | ||||
Indication for treatmentb | - | - | −0.027 (−0.139; 0.084) | 0.63 | ||||
CYP2C9*2 1-allele | - | - | −0.114 (−0.351; 0.124) | 0.35 | ||||
CYP2C9*2 2-alleles | - | - | - | - | ||||
CYP2C9*3 1-allele | - | - | −0.224 (−0.428; −0.020) | 0.03 | ||||
CYP2C9*3 2-alleles | - | - | −1.065 (−1.717; −0.412) | 0.002 | ||||
VK0RC1 AG | - | - | −0.422 (−0.574; −0.271) | < .0001 | ||||
VK0RC1 AA | - | - | −0.827 (−0.975; −0.679) | < .0001 | ||||
CYP4F2 CT | - | - | 0.117 (0.003; 0.231) | 0.04 | ||||
CYP4F2 TT | - | - | 0.124 (−0.075; 0.324) | 0.22 | ||||
BLACKS | ||||||||
Acenocoumarol | Warfarin | |||||||
Variable | Parameter estimate | P value | R2test (/V=0) | R2 validation (N = 0) | Parameter estimate | P value | R2 test (N = 534) | R2 validation (N = 288) |
Intercept | - | - | - | - | 3.875 (3.692; 4.061) | < 0.0001 | 0.30 | 0.22 |
Agea | - | - | −0.009 (−0.011; −0.006) | < 0.0001 | ||||
BMIa | - | - | 0.010 (0.007; 0.015) | < 0.0001 | ||||
Male gender | - | - | 0.152 (0.086; 0.219) | < 0.0001 | ||||
Indication for treatmentb | - | - | −0.090 (−0.160; −.0183) | 0.01 | ||||
CYP2C9*2 1-allele | - | - | −0.007 (−0.149;0.133) | 0.93 | ||||
CYP2C9*2 2-alleles | - | - | - | - | ||||
CYP2C9 *3 1-allele | - | - | −0.469 (−0.666; −0.270) | < 0.0001 | ||||
CYP2C9 *3 2-alleles | - | - | - | - | ||||
CYP2C9 *5 1-allele | - | - | −0.436 (−0.736; −0.137) | 0.005 | ||||
CYP2C9 *5 2-alleles | - | - | - | - | ||||
VK0RC1 AG | - | - | −0.284 (−0.585; −0.020) | 0.07 | ||||
VK0RC1 AA | - | - | −0.281 (−0.588; −0.020) | < 0.0001 | ||||
CYP4F2 CT | - | - | −0.0382 (−0.124; 0.050) | 0.40 | ||||
CYP4F2 TT | - | - | 0.300 (−0.068; 0.664) | 0.11 |
Statistical test for model fit (R2) is reported both for the test and validation cohorts. Due to significant heterogeneity, separate models are reported for different ethnic groups and drugs. BMI, body mass index; CI, confidence interval; CYP, cytochrome P450.
Estimate for 1 unit increase.
Estimate for the following indication for treatment: fibrillation/flutter, cardiomyopathy/left ventricular dilation, postorthopedic.