Association Between Genetic Variant Scores and Warfarin Effect

It is anticipated that next generation genomic sequencing will identify rare genetic variants
in ethnically diverse patient populations, which otherwise would not have been detected using
commercially available warfarin tests. Furthermore, retrospective review of clinical outcomes
(percent time in therapeutic range, time to reach therapeutic international normalized ratio
(INR), INR ≥ 4, major bleeding event, ischemic stroke) of study enrollees will determine the
clinical utility of genetic variant risk scores. Study outcomes will provide guidance on
future directions for optimizing dosing algorithms for warfarin that combine pharmacogenetic
principles with clinical dosing.

Inclusion Criteria:

1. Patients with non-valvular atrial fibrillation

2. Patients with deep venous thrombosis (DVT) with no hypercoagulable condition

3. Patients with non-valvular atrial fibrillation and DVT (with no hypercoagulable
condition)

4. Patients with intracardiac thrombosis (i.e. apical thrombosis, atrial thrombosis,
auricular thrombosis, mural thrombosis, and/or ventricular thrombosis)

5. Age 18-80 years

6. Signed informed consent

Exclusion Criteria:

1. Presence of a mechanical heart valve

2. Failure to provide signed informed consent

3. Known diseases that affects coagulation test results such as vitamin K deficiency,
disseminated intravascular coagulopathy, Von Willebrand disease, hemophilia, liver
failure, etc.

4. Taking any medication or on diet that affects coagulation test results such as:

Amiodarone, Anabolic Steroids, Fluconazole, Ketoconazole, Itraconazole, Aspirin and
Salicylates, Cephalosporins, Chloral Hydrate, Cimetidine, Clofibrate, Cranberry Juice,
Danazol, Diflunisal, Disulfiram, Fluvoxamine, Ginkgo Biloba, Heparin, Isoniazid (INH),
Erythromycin, Clarithromycin, Metronidazole, NSAIDS, Omeprazole, Paroxetine Pepto-Bismol,
Tamoxifen, Tetracycline, Ciprofloxacin, Levofloxacin, Moxifloxacin, Levothyroxine,
Ticlopidine, Trimethoprim-Sulfamethoxazole, Vitamin E, Barbiturates, Carbamazepine, Oral
contraceptives, Rifampin, Vitamin K, American Ginseng, Allopurinol, Corticosteroids
(Prednisone), Penicillin, Phenytoin