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Pharmacogenomics of renin angiotensin system inhibitors in coronary artery disease

James P Tsikouris1, Michael J Peeters

  • 1School of Pharmacy, University of Pittsburgh, 3501 Terrace Street, 808 Salk Hall, Pittsburgh, PA 15261, USA. jpt16@pitt.edu

Cardiovascular Drugs and Therapy
|May 9, 2007
PubMed

Insights

Genetic factors do not reliably predict how patients respond to Renin Angiotensin System (RAS) inhibitors for coronary artery disease (CAD). Current pharmacogenomic studies show conflicting results due to methodological issues, hindering personalized treatment strategies.

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Genetics

Background:

  • Renin Angiotensin System (RAS) inhibitors are widely used for coronary artery disease (CAD).
  • Significant variability exists in patient responses to these medications.
  • Genetic factors are being investigated as a source of this variability.

Purpose of the Study:

  • To review pharmacogenomic studies on RAS inhibitors in CAD.
  • To evaluate if RAS polymorphisms predict efficacy or elucidate mechanisms.
  • To identify limitations in current research approaches.

Main Methods:

  • Systematic review of published pharmacogenomic studies.
  • Analysis of studies using surrogate endpoints and clinical outcomes.
  • Evaluation of reported RAS polymorphisms and their association with RAS inhibitor response.

Main Results:

  • No RAS genotypes conclusively predicted the efficacy of RAS inhibitors across studies.
  • Conflicting results were frequently observed between different pharmacogenomic studies.
  • Methodological limitations, study design, and population differences contributed to inconsistent findings.

Conclusions:

  • Current evidence does not support using RAS genotypes to predict RAS inhibitor efficacy in CAD.
  • Significant methodological limitations plague existing pharmacogenomic research in this area.
  • Future research requires improved study designs and standardization to overcome inconsistencies and advance personalized medicine for CAD patients.

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