[The optimal treatment of chronic heart failure with beta-blockers may be dependent upon the genetic background of the patient].
Pharmacogenetics, which aims at the development of'personal pills', is an attractive field in modern medicine. However, the results obtained in the last few years are somewhat disappointing. Recently, a genetic polymorphism was discovered in the treatment of chronic heart failure with beta-blockers. An in-vitro study revealed a hypersensitivity of the Arg389 variant in the beta1-adrenergic receptor to the beta-blocker carvedilol. Interestingly, this polymorphism also has ethnic aspects: the allele frequency of the Arg389 variant is 20% lower in Negroes than in Caucasians. If this result can be confirmed in other studies, one should consider testing for this polymorphism before carvedilol is prescribed. The manufacturer of carvedilol might well consider offering to test the patient's DNA for this polymorphism.
Leschot
N J
NJ
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Klinische Genetica, Postbus 22.660, 1100 DB Amsterdam. n.j.leschot@amc.uva.nl
Wilde
A A M
AA
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D023281:Genomics; D005838:Genotype; D006333:Heart Failure / Q000188:drug therapy* / Q000235:genetics*; D006801:Humans; D010597:Pharmacogenetics; D011110:Polymorphism, Genetic; D011412:Propanolamines / Q000627:therapeutic use*; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol