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Heart Failure Pharmacogenetics: Past, Present, and Future

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Abstract

Heart failure is an increasingly common disease associated with significant morbidity and mortality in the aging population. Recent advances in heart failure pharmacotherapy have established several agents as beneficial to disease progression and outcomes. However, current consensus guideline-recommended pharmacotherapy may not represent an optimal treatment strategy in all heart failure patients. Specifically, individuals with genetic variation in regions central to mediation of beneficial response to standard heart failure agents may not receive optimal benefit from these drugs. Additionally, targeted approaches in phase 3 clinical trials that select patients for inclusion based on the genotype most likely to respond might advance the currently stalled drug development pipeline in heart failure. This article reviews the literature in heart failure pharmacogenetics to date, opportunities for discovery in recent and upcoming clinical trials, as well as future directions in this field.

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Abbreviations

A-HeFT:

African American Heart Failure Trial

BEST:

β-Blocker Evaluation in Survival Trial

CHARM:

Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity

MERIT-HF:

Metoprolol CR/XL Randomized Intervention Trial in Heart Failure

RALES:

Randomized Aldactone Evaluation Study

TOPCAT:

Aldosterone Antagonist Therapy for Adults with Heart Failure and Preserved Systolic Function

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Disclosure

Conflicts of interest: H.M. Davis: is a part-time pharmacist for CVS Pharmacy; J.A. Johnson: none.

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Authors and Affiliations

  1. Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, College of Pharmacy, University of Florida, Gainesville, FL, 32610, USA

    Heather M. Davis & Julie A. Johnson

  2. Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, 32610, USA

    Julie A. Johnson

  3. Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, P. O. Box 100486, Gainesville, FL, 32610, USA

    Julie A. Johnson

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  1. Heather M. Davis
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Correspondence to Julie A. Johnson.

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Davis, H.M., Johnson, J.A. Heart Failure Pharmacogenetics: Past, Present, and Future. Curr Cardiol Rep 13, 175–184 (2011). https://doi.org/10.1007/s11886-011-0181-6

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