Interaction of hemostatic genetics with hormone therapy: new insights to explain arterial thrombosis in postmenopausal women.
Genetic variants of key hemostatic mediators increasingly have been proposed as risk factors for atherothrombosis. The Hormone and Estrogen/Progestin Replacement Study group recently reported that the initiation of estrogen replacement in postmenopausal women with known coronary heart disease is associated with an early increase in cardiovascular events. A putative genetic susceptibility factor has been proposed a potential mediator of this increased event risk. This review outlines the recent literature to support the premise for this important proposal. Genetic profiling has great potential to improve the safety and efficacy of individualized pharmacotherapy in postmenopausal women and other at-risk populations for the prevention of cardiovascular disease.
Braunstein
Joel B
JB
The Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Divsion of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Kershner
Dawn Warner
DW
Bray
Paul
P
Gerstenblith
Gary
G
Schulman
Steven P
SP
Post
Wendy S
WS
Blumenthal
Roger S
RS
D001779:Blood Coagulation Factors / Q000235:genetics*; D001792:Blood Platelets / Q000502:physiology; D003327:Coronary Disease / Q000235:genetics / Q000503:physiopathology*; D015914:Estrogen Replacement Therapy; D005165:Factor V / Q000235:genetics; D005167:Factor VII / Q000502:physiology; D005260:Female; D005340:Fibrinogen / Q000502:physiology; D020022:Genetic Predisposition to Disease; D006487:Hemostasis / Q000235:genetics*; D006801:Humans; D017395:Plasminogen Activator Inhibitor 1 / Q000502:physiology; D017354:Point Mutation; D011110:Polymorphism, Genetic; D017698:Postmenopause / Q000502:physiology*; D011516:Prothrombin / Q000235:genetics; D013927:Thrombosis / Q000235:genetics* / Q000503:physiopathology*
D001779:Blood Coagulation Factors; D017395:Plasminogen Activator Inhibitor 1; D005165:Factor V; D005167:Factor VII; D011516:Prothrombin; D005340:Fibrinogen