title: Cardiovascular Pharmacogenomics--Implications for Patients With CKD.
abstract: CKD is an independent risk factor for cardiovascular disease (CVD). Thus, patients with CKD often require treatment with cardiovascular drugs, such as antiplatelet, antihypertensive, anticoagulant, and lipid-lowering agents. There is significant interpatient variability in response to cardiovascular therapies, which contributes to risk for treatment failure or adverse drug effects. Pharmacogenomics offers the potential to optimize cardiovascular pharmacotherapy and improve outcomes in patients with CVD, although data in patients with concomitant CKD are limited. The drugs with the most pharmacogenomic evidence are warfarin, clopidogrel, and statins. There are also accumulating data for genetic contributions to β-blocker response. Guidelines are now available to assist with applying pharmacogenetic test results to optimize warfarin dosing, selection of antiplatelet therapy after percutaneous coronary intervention, and prediction of risk for statin-induced myopathy. Clinical data, such as age, body size, and kidney function have long been used to optimize drug prescribing. An increasing number of institutions are also implementing genetic testing to be considered in the context of important clinical factors to further personalize drug therapy for patients with CVD.
authors.affiliation: Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, Gainesville, FL; Division of Nephrology and Hypertension, Albany Medical College, Albany, NY; and Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, NY. Electronic address: lcavallari@cop.ufl.edu.
authors.forename: Larisa H
authors.initials: LH
authors.lastname: Cavallari
authors.affiliation: Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, Gainesville, FL; Division of Nephrology and Hypertension, Albany Medical College, Albany, NY; and Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, NY.
authors.forename: Darius L
authors.initials: DL
authors.lastname: Mason
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000378:metabolism / Q000627:therapeutic use; D000925:Anticoagulants / Q000378:metabolism / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000209:etiology; D000077144:Clopidogrel; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics*; D005838:Genotype; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000378:metabolism*; D007166:Immunosuppressive Agents / Q000378:metabolism; D010597:Pharmacogenetics; D010641:Phenotype; D010975:Platelet Aggregation Inhibitors / Q000378:metabolism* / Q000627:therapeutic use; D057285:Precision Medicine; D058921:Purinergic P2Y Receptor Antagonists / Q000378:metabolism / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D000070590:Solute Carrier Proteins / Q000235:genetics*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000378:metabolism / Q000627:therapeutic use; D064417:Vitamin K Epoxide Reductases / Q000235:genetics; D014859:Warfarin / Q000008:administration & dosage / Q000378:metabolism*
chemical_list: D000319:Adrenergic beta-Antagonists; D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D000070590:Solute Carrier Proteins; D014859:Warfarin; D003577:Cytochrome P-450 Enzyme System; D000077144:Clopidogrel; C578523:VKORC1 protein, human; D064417:Vitamin K Epoxide Reductases; D013988:Ticlopidine
keywords: Clopidogrel; Genotype; Pharmacogenomics; Simvastatin; Warfarin