The Role of Pharmacogenomics in the Personalized Treatment for Acute Coronary Syndrome

The pharmacologic treatment of acute coronary syndrome (ACS) need to use multiple classes of medication with the aim of reducing major cardiovascular events, but the intersubject variability in the efficacy and adverse drug reactions (ADRs) exits. The clinical characteristics of patients (such as age, gender, race, obese, hypertension, and diabetes) and environmental risk factors (such as smoking and alcohol use) affect the drug efficacy and safety. Emerging evidence showed that genetic factors may significantly contribute to the individual variability observed in the response to ACS pharmacotherapy. The field of pharmacogenomics aims to discover these genetic determinants to identify individuals who are most likely to respond, experience an ADR, or benefit from an alternative dosing regimen for a given drug, and may eventually provide guidance to the optimized pharmacotherapy for ACS. In this review, we summarized the pharmacogenomic data related to cardiovascular drug efficacy and toxicity, including antiplatelet agents, anticoagulants, fibrinolytics, beta blockers, and neurohormonal inhibitors.