An Investigation of the Correlation Between the ABCB1 Rs4728709 Gene Polymorphism with Rivaroxaban Response and Bleeding Events in Patients with Atrial Fibrillation from Tthe Southern Region of Iraq

Abstract

Background:

Atrial fibrillation (AF) is a frequently occurring heart rhythm disorder that causes substantial morbidity and mortality due to thromboembolic events. Rivaroxaban, a direct oral anticoagulant (DOAC), is often prescribed to prevent strokes in patients with non-valvular AF. However, the impact of genetic variables on the pharmacokinetics and clinical effects of rivaroxaban in patients with non-valvular atrial fibrillation (NVAF) in Iraq still insufficiently explored.

Aim of Study:

This study explores the link between the single-nucleotide polymorphism (SNP) in the ABCB1 gene (rs4728709 G>A), rivaroxaban response, and the occurrence of bleeding events in patients with atrial fibrillation (AF).

Patients and Methods:

This cross-sectional study examines patients with atrial fibrillation (AF) treated with rivaroxaban anticoagulation from September 2024 to March 2025 in Iraq. We gathered clinical data covering demographics, comorbidities, and treatment adherence. Biochemical tests assessed coagulation parameters (INR, PT) and complete blood count (CBC) for (HB, PLT). Genotyping for the ABCB1 SNP was conducted using allele-specific polymerase chain reaction (AS-PCR).

Results:

This study included 100 participants, comprising 45 males and 55 females, predominantly over 46, and exhibited a high obesity rate of 52%. The genotype distribution for rs4728709 was 72% GG, 13% GA, and 15% AA. The rs4728709 polymorphism was not significantly associated with rivaroxaban response and occurrences of bleeding events.

Conclusion:

The rs4728709 polymorphism in the ABCB1 gene showed no significant association with rivaroxaban response or bleeding events among Iraqi patients with non-valvular atrial fibrillation, indicating limited pharmacogenomic relevance of this SNP in anticoagulation response within the studied population.