Review ArticleGenetic Tailoring of Pharmacotherapy in Heart Failure: Optimize the Old, While We Wait for Something New
Section snippets
Methods
Beta-blocker and ACE inhibitor pharmacogenetic studies were identified in the Pubmed database from 1966 to July 2011 by combining the following search terms: heart failure, variant, polymorphism, pharmacogenetics, pharmacogenomics, beta-blocker, ACE inhibitor, and each individual drug name. Studies were also identified from the reference lists of articles. Studies were limited to those performed in patients with HF and those published in English.
Beta-Blockers
Thirty beta-blocker pharmacogenetic studies in patients with HF have been published from 2000 to 2011, and the genetic variants studied for an association with (FDA-approved) beta-blocker response in HF patients are summarized in Table 1. These studies are heterogeneous in many aspects: design, sample size, end point, HF patient population, specific beta-blockers, and genetic variants tested. The study designs include retrospective and prospective nonrandomized cohorts, pharmacogenetic
Discussion
The first report of a pharmacogenetic interaction in HF patients was published 13 years ago.59 Since then, the work of Liggett et al concerning the investigational drug bucindolol provides the best evidence yet to support that genetic variation can be associated with differential response to HF pharmacotherapy, which can in turn affect the risk of adverse outcomes. Unfortunately, the literature as a whole does not provide sufficient evidence to guide application of available HF drug therapy
Disclosures
None.
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Funding: J.A.T. is supported by a predoctoral fellowship from the American Foundation for Pharmaceutical Education.
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