Pharmacogenomics and Cardiovascular Disease
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Variability in drug responsiveness is a sine qua non of modern therapeutics, and the contribution of genomic variation is increasingly recognized. Investigating the genomic basis for variable responses to cardiovascular therapies has been a model for pharmacogenomics in general and has established critical pathways and specific loci modulating therapeutic responses to commonly used drugs such as clopidogrel, warfarin, and statins. In addition, genomic approaches have defined mechanisms and genetic variants underlying important toxicities with these and other drugs. These findings have not only resulted in changes to the product labels but also have led to development of initial clinical guidelines that consider how to facilitate incorporating genetic information to the bedside. This review summarizes the state of knowledge in cardiovascular pharmacogenomics and considers how variants described to date might be deployed in clinical decision making.
KeywordsPharmacogenomics Polymorphism Genetics Clopidogrel Warfarin Statin Beta-blocker, Anti-arrhythmic agents Cardiovascular disease Drug responsiveness Toxicity
Clinical Trial Acronyms
Beta-Blocker Evaluation of Survival Trial Among Patients on Bucindolol
Perindopril Genetic Association Study
Perindopril Protection Against Recurrent Stroke Study
Peter Weeke is funded by an unrestrictive grant from the Tryg Foundation (J.nr. 7343–09, TrygFonden, Denmark). Supported in part by U19 HL065962. Dan M. Roden has received grant support from NIH.
Compliance with Ethics Guidelines
Conflict of Interest
Peter Weeke declares that he has no conflict of interest.
Dan M. Roden has received the following patents/royalties: U.S. Letters Patents No. 6456542, issued October 1, 2002 for ‘Method of Screening for Susceptibility to Drug-Induced Cardiac Arrhythmia.’
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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