Use of genetic data to guide therapy in arterial disease

J Thromb Haemost. 2015 Jun;13 Suppl 1:S281-9. doi: 10.1111/jth.12924.

Abstract

There is considerable interindividual variation in the response to antiplatelet and anticoagulant therapies. It has been proposed that this variability in drug response may be attributable to genetic variants. Thus, pharmacogenetics may help to accurately predict response to cardiovascular disease (CVD) therapies in order to maximize drug efficacy, minimize drug toxicity, and to tailor personalized care for these patients. Although the clinical utility of pharmacogenetics is promising, its adoption in clinical practice has been slow. This resistance may stem from sometimes conflicting findings among pharmacogenetic studies. Thus, this review focuses on the genetic determinants of commonly used platelet antagonists and anticoagulants including aspirin, clopidogrel, dabigatran, and warfarin. We also explore the clinical translation of pharmacogenetics in the management of patients with CVD.

Keywords: anticoagulants; cardiovascular diseases; genetics; pharmacogenetics; platelet aggregation inhibitors.

Publication types

  • Review

MeSH terms

  • Animals
  • Anticoagulants / adverse effects
  • Anticoagulants / pharmacokinetics
  • Anticoagulants / therapeutic use*
  • Biotransformation
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / drug therapy*
  • Drug Resistance
  • Genotype
  • Humans
  • Pharmacogenetics*
  • Phenotype
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / pharmacokinetics
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Precision Medicine*
  • Risk Factors
  • Treatment Outcome

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors