Pharmacogenomics and risk stratification in cardiovascular care: Insights from randomized controlled trials

Genomics and personalized medicine are transforming cardiology by improving the assessment, diagnosis, and treatment of cardiovascular diseases (CVDs). By understanding the genetic factors underlying CVDs, personalized treatment strategies can be developed to enhance patient outcomes and reduce the burden of cardiovascular conditions. The integration of genomics into clinical practice enables more precise risk assessments, early detection, and targeted interventions. This narrative review examines randomized clinical trials (RCTs) on genotype-guided therapies, pharmacogenomics, and personalized medicine in cardiology. Studies were selected for their contributions to identifying genetic factors influencing CVD risk, evaluating pharmacogenomic data, and exploring personalized treatment approaches. Key outcomes analyzed include treatment efficacy, genetic associations, and clinical implications of genetic insights in cardiovascular care. The findings highlight the identification of genetic variants linked to increased CVD risk and the development of genomic risk scores for personalized risk prediction. Pharmacogenomic studies also revealed genetic determinants of drug response, particularly in cardiovascular treatments. Genetic testing has shown promise in guiding antiplatelet therapy selection, drug dosage optimization, and minimizing adverse effects, thus improving treatment efficacy. Despite the potential of genomics and personalized medicine, challenges such as clinical implementation, cost-effectiveness, and ethical concerns persist. To fully benefit from personalized cardiovascular care, future research should focus on validating genetic markers, refining risk prediction models, and overcoming barriers to widespread adoption. With continued development, these approaches could revolutionize cardiovascular care, providing more effective, individualized treatments and improving patient outcomes.