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Review ArticleReview Article

Pharmacogenetics and Cardiovascular Disease—Implications for Personalized Medicine

Julie A. Johnson and Larisa H. Cavallari
Rhian M. Touyz, ASSOCIATE EDITOR
Pharmacological Reviews July 2013, 65 (3) 987-1009; DOI: https://doi.org/10.1124/pr.112.007252
Julie A. Johnson
Center for Pharmacogenomics, Department of Pharmacotherapy and Translational Research and Department of Medicine, Colleges of Pharmacy and Medicine, University of Florida, Gainesville, Florida (J.A.J.); and the Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois (L.H.C.)
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Larisa H. Cavallari
Center for Pharmacogenomics, Department of Pharmacotherapy and Translational Research and Department of Medicine, Colleges of Pharmacy and Medicine, University of Florida, Gainesville, Florida (J.A.J.); and the Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois (L.H.C.)
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Rhian M. Touyz
Center for Pharmacogenomics, Department of Pharmacotherapy and Translational Research and Department of Medicine, Colleges of Pharmacy and Medicine, University of Florida, Gainesville, Florida (J.A.J.); and the Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois (L.H.C.)
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Abstract

The past decade has seen tremendous advances in our understanding of the genetic factors influencing response to a variety of drugs, including those targeted at treatment of cardiovascular diseases. In the case of clopidogrel, warfarin, and statins, the literature has become sufficiently strong that guidelines are now available describing the use of genetic information to guide treatment with these therapies, and some health centers are using this information in the care of their patients. There are many challenges in moving from research data to translation to practice; we discuss some of these barriers and the approaches some health systems are taking to overcome them. The body of literature that has led to the clinical implementation of CYP2C19 genotyping for clopidogrel, VKORC1, CYP2C9; and CYP4F2 for warfarin; and SLCO1B1 for statins is comprehensively described. We also provide clarity for other genes that have been extensively studied relative to these drugs, but for which the data are conflicting. Finally, we comment briefly on pharmacogenetics of other cardiovascular drugs and highlight β-blockers as the drug class with strong data that has not yet seen clinical implementation. It is anticipated that genetic information will increasingly be available on patients, and it is important to identify those examples where the evidence is sufficiently robust and predictive to use genetic information to guide clinical decisions. The review herein provides several examples of the accumulation of evidence and eventual clinical translation in cardiovascular pharmacogenetics.

Footnotes

  • This work was supported in part by the National Institutes of Health [Grants U01 GM074492 and R01 NS073346] (to J.A.J.); and the American Heart Association Midwest Affiliate [Grant 10GRNT3750024] (to L.H.C.).

  • dx.doi.org/10.1124/pr.112.007252.

  • Copyright © 2013 by The American Society for Pharmacology and Experimental Therapeutics
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Pharmacological Reviews: 65 (3)
Pharmacological Reviews
Vol. 65, Issue 3
1 Jul 2013
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Review ArticleReview Article

Cardiovascular Pharmacogenetics and Personalized Medicine

Julie A. Johnson and Larisa H. Cavallari
Pharmacological Reviews July 1, 2013, 65 (3) 987-1009; DOI: https://doi.org/10.1124/pr.112.007252

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Review ArticleReview Article

Cardiovascular Pharmacogenetics and Personalized Medicine

Julie A. Johnson and Larisa H. Cavallari
Pharmacological Reviews July 1, 2013, 65 (3) 987-1009; DOI: https://doi.org/10.1124/pr.112.007252
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  • Article
    • Abstract
    • I. Introduction
    • II. Implementing Pharmacogenetics in the Clinical Setting
    • III. Clopidogrel Pharmacogenetics
    • IV. Warfarin Pharmacogenetics
    • V. Statin Pharmacogenetics
    • VI. Other Examples in Cardiovascular Pharmacogenetics
    • VII. Summary
    • Authorship Contributions
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