title: [Pharmacogenetic study of the response to flecainide and propafenone in patients with atrial fibrillation].
abstract: We analyzed cytochrome P450 2D6 polymorphism by determining phenotype as the metabolic ratio between dextromethorphan and its main metabolite, dextrorphan. We studied 18 men and 22 women in whom mean age was 54.6+/-11.9 years. In 9 patients metabolic ratio was determined before antiarrhythmic treatment and again during treatment, with a mean increase of 0.13+/-0.15 (P=.03). We found 19 poor metabolizers and 21 extensive metabolizers. Adverse effects were more frequent in poor metabolizers (21.1%) than in extensive metabolizers (4.8%; P=.12). Antiarrhythmic treatment was effective in 27 patients (67.5%), with no difference between poor and extensive metabolizers.
authors.affiliation: Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Martínez-Sellés
authors.forename: Isabel
authors.initials: I
authors.lastname: Castillo
authors.forename: Pilar
authors.initials: P
authors.lastname: Montenegro
authors.forename: María L
authors.initials: ML
authors.lastname: Martín
authors.forename: Jesús
authors.initials: J
authors.lastname: Almendral
authors.forename: María
authors.initials: M
authors.lastname: Sanjurjo
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics* / Q000378:metabolism*; D005260:Female; D005424:Flecainide / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010597:Pharmacogenetics; D011110:Polymorphism, Genetic; D011405:Propafenone / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D011405:Propafenone; D019389:Cytochrome P-450 CYP2D6; D005424:Flecainide