Cardiovascular pharmacogenomics; state of current knowledge and implementation in practice

Area of Science:

• Pharmacogenomics
• Cardiovascular pharmacology
• Genetics and drug metabolism

Background:

• Pharmacogenomics (PGx) investigates how individual genetics influence drug safety and efficacy.
• Cardiovascular (CV) medication PGx is a leading translated area, but clinical implementation lags behind scientific understanding.
• Regulatory bodies (FDA) and expert networks (CPIC) are actively working to bridge this gap.

Purpose of the Study:

• To review the current knowledge of pharmacogenomics in cardiovascular medications.
• To describe resources facilitating the clinical translation of PGx data.
• To comprehensively discuss existing PGx literature for common CV drugs.

Main Methods:

• Literature review of pharmacogenomics in cardiovascular medicine.
• Analysis of guidelines and drug labeling updates from regulatory and expert bodies.
• Discussion of clinical trial data and evidence for genotype-guided dosing.

Main Results:

• PGx knowledge is robust for certain CV drugs (e.g., clopidogrel, warfarin, simvastatin), leading to CPIC guidelines and FDA labeling changes recommending genotype-guided dosing.
• For other CV drugs, PGx studies show conflicting results, necessitating further large-scale clinical trials.
• Resources and facilities supporting PGx data translation into clinical practice are identified.

Conclusions:

• Pharmacogenomics offers significant potential for optimizing cardiovascular drug therapy.
• Clinical implementation of PGx for CV drugs requires continued research, guideline development, and regulatory support.
• Translating PGx findings into routine clinical practice is crucial for personalized cardiovascular medicine.