在冠状动脉疾病的老年患者中,基于药物遗传学小组对临床结果的预测
Lisha Dong1,2, Shizhao Zhang1,2, Chao Lv1
1Institute of Geriatrics, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
Pharmaceutics
|August 29, 2024
概括
在多药房治疗的老年冠状动脉疾病 (CAD) 患者的药物遗传学测试显示,80.3%的人具有可操作的药物基因对. 携带者状态预测临床结果,这表明药物遗传学小组指导的治疗可以改善患者的结果.
科学领域:
- 药物基因组学 药物基因组学
- 心血管医学 心血管医学
- 老年病的医生 老年病的医生
背景情况:
- 已知影响心血管药物疗效的可操作的药物遗传变异,但它们对冠状动脉疾病 (CAD) 的老年患者对多药物的影响尚不清楚.
- 老年CAD患者的多药性增加了药物不良反应和次优治疗结果的风险.
- 了解药物基因相互作用对于优化这种脆弱人群的治疗至关重要.
研究的目的:
- 研究可操作的药物遗传变异对接受多药治疗的老年CAD患者临床结果的影响.
- 确定药物基因对与主要不良心血管事件 (MACE),全因死亡率和不良药物反应 (ADR) 之间的关联.
- 评估药物遗传学小组指导多药学的潜力,以改善患者的治疗结果.
主要方法:
- 招募了892名患有CAD和多药的老年患者 (平均年龄为80.7岁) 的队列.
- 对10种药物基因中的13种变异进行了基因定型,这些变异与12种常见的CAD药物相关.
- 统计分析,包括调整的危险比率和卡普兰-梅尔生存曲线,用于评估4年随访期间的结果.
主要成果:
- 80.3%的患者至少有一个可操作的药物基因对,需要治疗药物改变.
- 药物基因对的数量独立地与MACE风险降低 (aHR:0.803) 和全因死亡率 (aHR:0.848) 相关.
- 观察到更多的药物基因对增加了副作用的风险 (aHR: 1.170),而任何药物基因对的患者与没有 (HR: 0.556) 的患者相比,MACE的风险明显较低.
结论:
- 可操作的药物基因对的载体状况可以预测多药的老年CAD患者的临床结果.
- 实施先发性药物遗传学小组指导的多药学可能会改善这一患者群体的临床结果.
- 药物遗传学见解对于老年人个性化心血管药物治疗至关重要.
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