Pharmacogenomics in acute coronary syndrome
Cornelia Remmler1, Ingolf Cascorbi
1Institute of Pharmacology, University Hospital Schleswig-Holstein, Hospitalstr. 4, D-24105 Kiel, Germany.
Expert Opinion on Pharmacotherapy
|January 29, 2008
Summary
Genetic variants
Area of Science:
- Cardiovascular pharmacogenomics and personalized medicine.
Background:
- Cardiovascular diseases have been extensively studied for genetic inheritance.
- The influence of genetic variants on drug response in cardiovascular conditions is less understood.
- Inter-individual differences in pharmacokinetics and pharmacodynamics impact treatment outcomes.
Purpose of the Study:
- To review the role of genetic polymorphisms in drug response for acute coronary syndromes.
- To assess the current evidence for pharmacogenomics in cardiovascular disease treatment.
Main Methods:
- Review of retrospective candidate gene studies and genome-wide investigations.
- Focus on polymorphic platelet aggregation, clotting factors, vascular function, and lipid metabolism.
- Analysis of existing evidence on genetic influences on drug response.
Main Results:
- Evidence for genetic influence on short-term acute coronary syndrome treatment is weak, except for Vitamin K antagonists.
- Findings regarding genetic polymorphisms in cardiovascular drug response are often complex, contradictory, or unreproducible.
- The current picture of pharmacogenomics in cardiovascular disease is intricate.
Conclusions:
- Statistically robust, prospective studies are needed to evaluate the impact of pharmacogenomics.
- Multiple genetic traits must be considered for accurate assessment of pharmacogenomic impact.
- Currently, no genetic data should influence acute treatment decisions for acute coronary syndromes, but may inform future long-term strategies.
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