Association Between ABCG2 Polymorphism and Statin-Induced Adverse Events: A Meta-Analysis

Cardiovasc Toxicol. 2025 Nov;25(11):1761-1767. doi: 10.1007/s12012-025-10056-w. Epub 2025 Aug 23.

Abstract

Statins, widely used for preventing cardiovascular diseases due to their cholesterol-lowering effects, are associated with potential adverse reactions in some individuals, underscoring the need to understand the factors contributing to statin-related complications. The ATP-binding cassette subfamily G member 2 (ABCG2) gene, which encodes a multidrug transporter, has garnered attention due to its involvement in statin metabolism. Specifically, the rs2231142 polymorphism within ABCG2 has been implicated in altered drug metabolism and pharmacokinetics, potentially influencing statin-related toxicity. Despite previous investigations, findings regarding this association remain inconclusive. Thus, this systematic review and meta-analysis aimed to clarify the correlation between the rs2231142 polymorphism and statin-induced toxicity. Through a comprehensive literature search, seven eligible studies were identified and subjected to rigorous data extraction and quality assessment. Meta-analysis revealed a significant association between the rs2231142 polymorphism and an increased risk of overall statin-induced toxicity, including muscular and hepatic toxicity, with odds ratios of 2.6 and 2.7, respectively. These findings suggest a potential role for ABCG2 polymorphisms in statin-related adverse events and emphasize the importance of personalized treatment strategies in managing statin therapy.

Keywords: ABCG2; ATP binding cassette subfamily G member 2; Meta-analysis; Statin; Toxicity.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily G, Member 2* / genetics
  • ATP Binding Cassette Transporter, Subfamily G, Member 2* / metabolism
  • Chemical and Drug Induced Liver Injury* / diagnosis
  • Chemical and Drug Induced Liver Injury* / genetics
  • Genetic Association Studies
  • Genetic Predisposition to Disease
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Muscular Diseases* / chemically induced
  • Muscular Diseases* / genetics
  • Neoplasm Proteins* / genetics
  • Neoplasm Proteins* / metabolism
  • Pharmacogenomic Variants*
  • Phenotype
  • Polymorphism, Single Nucleotide*
  • Risk Assessment
  • Risk Factors

Substances

  • ATP Binding Cassette Transporter, Subfamily G, Member 2
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • ABCG2 protein, human
  • Neoplasm Proteins