Current Role of Pharmacogenomics in Cardiovascular Medicine
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Pharmacogenomics holds the promise of transforming patient care by allowing providers to tailor therapy to each individual patient based on his or her genetic information. Although no established pharmacogenomic applications in cardiovascular medicine yet exist, there are at least three emerging applications that may ultimately become routine clinical practice; these are related to warfarin, clopidogrel, and statins. Of the three, warfarin pharmacogenomics has been the most rigorously evaluated to date, with several clinical trials either completed or underway. Clopidogrel pharmacogenomics has a growing body of supporting scientific evidence and warrants evaluation in prospective clinical trials. Statin pharmacogenomics remains the least developed application, with controversy surrounding a widely marketed genetic test whose validity has been questioned by recent evidence. Providers are advised to take a “wait and see” approach to pharmacogenomics at the present time, with the expectation that it will be a few years before any cardiovascular pharmacogenomic application is unequivocally proven to be both cost-effective as well as of clinical benefit.
The author reports no potential conflict of interest relevant to this article.
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- 12.Anderson JL, Adams CD, Antman EM, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 2002 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction): developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons: endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. Circulation. 2007;11:e148–304.Google Scholar
- 13.Kushner FG, Hand M, Smith Jr SC, et al. 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009;120:2271–306.PubMedCrossRefGoogle Scholar
- 24.Abraham NS, Hlatky MA, Antman EM, et al. ACCF/ACG/AHA 2010 Expert Consensus Document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation. 2010;122:2619–33.PubMedCrossRefGoogle Scholar