Present status of outcome prediction of invasive coronary treatment by using genetic markers

A growing number of studies suggest that the outcome after invasive coronary treatment may be in part genetically determined. Here, we review the present status of outcome prediction of invasive coronary treatments by using genetic markers. Although some studies found an association between one or another genetic marker with one or another clinical endpoint, many other studies found no such relations; to date, none of the genetic markers that have been investigated in association studies are used in routine clinical practice to prospectively assess the prognosis following invasive coronary treatment or to decide upon therapeutic strategies. Many associations between genetic markers and certain clinical endpoints were initially reported in small studies but could not be confirmed in larger ones. Some of these discrepancies may be explained by publication bias. Some genetic variants may have true effects on clinical endpoints, which, albeit biologically interesting, do not bear much clinical relevance. On the other hand, many-if not most-studies that have been published to date are more or less grossly underpowered and very rarely report on the results of an a priori power analysis. Thus, there is still a need for further high-quality studies designed to investigate the specific contribution of genetic factors to the outcome after invasive coronary interventions.