Husna Rahim, PharmD & Jennifer Tovar, PharmD
Pharmacogenomics in Cardiovascular Diseases – Making Your Treatment Better. What is the current role of precision medicine in treating cardiovascular diseases (CVDs)? The rapidly evolving field of pharmacology and genomics offers clinically-actionable insights to accelerate the benefits of genomic medicine for patients and healthcare professionals. Pharmacogenomic (PGx) research has identified genetic variants impacting responses to mainstay heart medications including clopidogrel, warfarin and statins (Bielinski, 2020).
30% of patients have Impaired antiplatelet response. A study published in the Journal of the American College of Cardiology demonstrated the effect of genetic variations on the blood thinner clopidogrel. According to the study, approximately 30% of people have CYP2C19 mutations that result in decreased enzyme activity, leading to reduced effectiveness of clopidogrel (Beitelshees, 2022). Identifying genetic markers linked to clopidogrel resistance allows clinicians to tailor antiplatelet medication, leading to improved outcomes for patients with heart disease and all patients on blood thinners.
Statin use and muscle pain. Anticoagulant therapy with warfarin also exhibits wide interpatient variability in dosing requirements influenced by genetic factors. Genetic testing for variations in the CYP2C9 and VKORC1 genes can predict warfarin dosing requirements, reducing the risk of adverse events and improving therapeutic outcomes. Warfarin dosing based on PGx led to fewer hospitalizations, major bleeding events, and thromboembolic complications than standard dosing, according to a study in the American Journal of Cardiology.
PGx testing is also helpful in identifying patients who may be predisposed to experiencing myopathy, or muscle cramps, as a side effect of statin use. In rare cases, patients may even sustain muscle damage, a serious adverse event known as rhabdomyolysis. A 2020 study found that 29% of participants had an indicated simvastatin myopathy risk based on SLCO1B1 genotype (Vassy, 2020). It demonstrated that proactive genomic testing interpretation and preemptive SLCO1B1 genotyping reduced statin-associated muscle symptoms.
The future of cardiology practice. Overall, there is great potential to leverage pharmacogenomic data to improve medication safety, efficacy, and patient outcomes in the treatment of cardiovascular conditions. As research continues to unravel the complex interplay between genetics and drug therapy, personalized medicine will undoubtedly shape the future of cardiology practice.
Learn more about UGenome’s Personalized Medication Service, ProPEx, or contact UGenome. You can also find case studies for UGenome’s bioinformatics services Metabolite Identification, Bone Metastasis Risk Analysis in Breast Cancer, Survival Analysis with gene signatures in cancer
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