Pharmacogenomic Challenges in Cardiovascular Diseases: Examples of Drugs and Considerations for Future Integration in Clinical Practice
2017
Introduction: Even if cardiovascular disease (CVD) drugs are supported by high level
proofs, the results of CVD treatment present great disparities: there are still patients dying with supposed
optimal treatment, patients facing adverse events and CVD remains the primary cause of death
in the world. Pharmacogenomics is the basis of personalisation of the treatment able to allow higher
medication success rates. In this review, we will present detailed examples of CVD drugs to highlight
the complexity of this challenging field and we will discuss novel concepts that should be considered
for a fastest integration of pharmacogenomics in clinical practice of CVD.
Areas Covered: The complexity of pharmacogenetics and pharmacogenomics of CVD drugs are presented
though examples of medications such as statins, with a focus on their effectiveness and adverse effects.
Expert Opinion: The application of personalised medicine in the CVD medical practice requires the
study of human genome with regard to drugs pharmacokinetics, pharmacodynamics, interactions and
tolerance profile. The existing state –of-the-art of CVD drugs gives hopes for a future revolution in the
drug development that will maximise cardiovascular patients benefit while decreasing their risks for
adverse effects.
Article Highlights Box:
• Coronary heart disease (CHD) remains the first cause of death worldwide.
• Cardiovascular treatment has a significant percentage of insufficient efficacy, poor tolerance
and compliance.
• Predicting the response to therapy while diminishing the side effects is the basis of personalised
medicine; pharmacogenomics is leading towards this direction.
• The response to CVD therapy and side effects are in the heart of CVD pharmacogenomics and
significant progress has been noted.
• The application of pharmacogenomics in the CVD medical practice is facing many methodological,
technical, ethical, behavioral and financial issues, while cost-effectiveness is the main prerequisite.
• The consideration of gene × gene × environment interactions and the inclusion of “omics” data
in pharmacogenomic studies of CVD drugs will facilitate the generation of reliable results and
will promote tailored treatments and new strategies of drug research and development.
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