title: [Cardiovascular pharmacogenomics].
abstract: Cardiovascular disease remains a major cause of morbidity and mortality worldwide. Current medical practice takes into account information based on population studies and benefits observed in large populations or cohorts. However, individual patients present great differences in both toxicity and clinical efficacy that can be explained by variations in adherence, unknown drug to drug interactions and genetic variability. The latter seems to explain from 20% up to 95% of patient to patient variability. Treating patients with cardiovascular disorders faces the clinician with the challenge to include genomic analysis into daily practice. There are several examples within cardiovascular disease of treatments that can vary in toxicity or clinical usefulness based on genetic changes. One of the main factors affecting the efficacy of Clopidogrel is the phenotype associated with polymorphisms in the gene CYP 2C9. Furthermore, regarding oral anticoagulants, changes in CYP2C9 and VKORC1 play an important role in changing the clinical response to anticoagulation. When analyzing statin treatment, one of their main toxicities (myopathy) can be predicted by the SLCO1B1 polymorphism. The potential for prediction of toxicity and clinical efficacy from the use of genetic analysis warrants further studies aiming towards its inclusion in daily clinical practice.
authors.affiliation: Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Paula
authors.initials: P
authors.lastname: Scibona
authors.affiliation: Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Cátedra de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina. Electronic address: federico.angriman@hospitalitaliano.org.ar.
authors.forename: Federico
authors.initials: F
authors.lastname: Angriman
authors.affiliation: Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Ventura
authors.initials: V
authors.lastname: Simonovich
authors.affiliation: Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Martina M
authors.initials: MM
authors.lastname: Heller
authors.affiliation: Sección de Farmacología Clínica, Servicio de Clínica Médica, Departamento de Medicina, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Cátedra de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Waldo H
authors.initials: WH
authors.lastname: Belloso
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000235:genetics*; D000077144:Clopidogrel; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011110:Polymorphism, Genetic; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
keywords: Argentina; Clopidogrel; Estatinas; Farmacogenómica; Pharmacogenomic; Polimorfismo; Polymorphism; Statin; Warfarin; Warfarina