Association of ABCB1 gene polymorphisms rs1128503, rs2032582, rs4148738 with anemia in patients receiving dabigatran after total knee arthroplasty  

作　　者：Alina Kasimova Dmitry Labutin Anton Gvozdetsky Svetlana Bozhkova 

机构地区：[1]Division of Wound Infection Prevention and Treatment,Vreden National Medical Research Center of Traumatology and Orthopaedics,St.Petersburg,Russian Federation [2]Department of Clinical Pharmacology and Evidence-based Medicine,Pavlov First Saint Petersburg State Medical University,St.Petersburg,Russian Federation [3]Department of Psychiatry and Addictology,North-Western State Medical University named after I.I.Mechnikov,St.Petersburg,Russian Federation

出　　处：《Chinese Journal of Traumatology》2024年第1期27-33,共7页中华创伤杂志（英文版）

基　　金：supported by the Vreden National Medical Research Center of Traumatology and Orthopaedics。

摘　　要：Purpose:Dabigatran is usually prescribed in recommended doses without monitoring of the blood coagulation for the prevention of venous thromboembolism after joint arthroplasty.ABCB1 is a key gene in the metabolism of dabigatran etexilate.Its allele variants are likely to play a pivotal role in the occurrence of hemorrhagic complications.Methods:The prospective study included 127 patients with primary knee osteoarthritis undergoing total knee arthroplasty.Patients with anemia and coagulation disorders,elevated transaminase and creatinine levels as well as already receiving anticoagulant and antiplatelet therapy were excluded from the study.The association of ABCB1 gene polymorphisms rs1128503,rs2032582,rs4148738 with anemia as the outcome of dabigatran therapy was evaluated by single-nucleotide polymorphism analysis with a realtime polymerase chain reaction assay and laboratory blood tests.The beta regression model was used to predict the effect of polymorphisms on the studied laboratory markers.The probability of the type 1 error(p)was less than 0.05 was considered statistically significant.BenjaminiHochberg was used to correct for significance levels in multiple hypothesis tests.All calculations were performed using Rprogramming language v3.6.3.Results:For all polymorphisms there was no association with the level of platelets,protein,creatinine,alanine transaminase,prothrombin,international normalized ratio,activated partial thromboplastin time and fibrinogen.Carriers of rs1128503(TT)had a significant decrease of hematocrit(p=0.001),red blood count and hemoglobin(p=0.015)while receiving dabigatran therapy during the postoperative period compared to the CC,CT.Carriers of rs2032582(TT)had a significant decrease of hematocrit(p=0.001),red blood count and hemoglobin(p=0.006)while receiving dabigatran therapy during the postoperative period compared to the GG,GT phenotypes.These differences were not observed in carriers of rs4148738.Conclusion:It might be necessary to reconsider thromboprophylaxis with dabigatran in

关 键 词：THROMBOPROPHYLAXIS P-GLYCOPROTEIN DABIGATRAN ANEMIA SNPs 

分 类 号：R687.4[医药卫生—骨科学]