Friday, August 27, 2010

Warfarin genotyping

Here are a couple of videos from Mayo.








This is research information to change practice now. The effectiveness, however, may be limited by turnaround time. How is it important for hospitalists? Suppose you're planning an early discharge of a patient with DVT or low risk PE. Genotyping, if turnaround time is reasonable, could greatly simplify discharge planning and the transition to ambulatory care. Up to now it's been largely guesswork. What warfarin dose? When should they get their first post hospital INR? Will the PCP monitor it appropriately? What's the anticipated duration of low molecular weight heparin? How confident can I be that the patient will be therapeutic within so many days without overshoot? Genotyping may reduce the guesswork and make for a smoother transition.

H/T to Clinical Cases and Images.

We discussed this and other important developments in genetics at this meeting. More on that soon.

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