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. 2016 Sep;4(3):119-129.
doi: 10.1007/s40142-016-0096-z. Epub 2016 Jun 16.

Pharmacogenetics in Cardiovascular Medicine

Sony Tuteja  1 , Nita Limdi  2   3
Affiliations

Pharmacogenetics in Cardiovascular Medicine

Sony Tuteja et al. Curr Genet Med Rep. 2016 Sep.

Abstract

Purpose of review: Pharmacogenetics is an important component of precision medicine. Even within the genomic era, several challenges lie ahead in the road towards clinical implementation of pharmacogenetics in the clinic. This review will summarize the current state of knowledge regarding pharmacogenetics of cardiovascular drugs, focusing on those with the most evidence supporting clinical implementation- clopidogrel, warfarin and simvastatin.

Recent findings: There is limited translation of pharmacogenetics into clinical practice primarily due to the absence of outcomes data from prospective, randomized, genotype-directed clinical trials. There are several ongoing randomized controlled trials that will provide some answers as to the clinical utility of genotype-directed strategies. Several academic medical centers have pushed towards clinical implementation where the clinical validity data are strong. Their experiences will inform operational requirements of a clinical pharmacogenetics testing including the timing of testing, incorporation of test results into the electronic health record, reimbursement and ethical issues.

Summary: Pharmacogenetics of clopidogrel, warfarin and simvastatin are three examples where pharmacogenetics testing may provide added clinical value. Continued accumulation of evidence surrounding clinical utility of pharmacogenetics markers is imperative as this will inform reimbursement policy and drive adoption of pharamcogenetics into routine care.

Keywords: cardiovascular; clinical implementation; clopidogrel; pharmacogenetics; precision medicine; simvastatin; warfarin.

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References

    1. Precision Medicine Initiative Cohort Program. Working Group Report. [Accessed March 8, 2016];2015 https://www.nih.gov/precision-medicine-initiative-cohort-program. The Precision Medicine Working Group Report outlines the plan for building the one million Americans cohort, enabling precision medicine discoveries at an accerlated pace.
    1. PGRN: Pharmacogenomics Research Network. [accessed March 8, 2016]; http://www.nhlbi.nih.gov/research/resources/genetics-genomics/pgrn.
    1. CPIC: Clinical pharmacogenetics implementation consortium. [accessed March 8, 2016]; https://cpicpgx.org/
    1. Scott SA, Sangkuhl K, Stein CM, et al. Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C19 Genotype and Clopidogrel Therapy: 2013 Update. Clin Pharmacol Ther. 2013;94:317–23. The CPIC guidelines for warfarin provide peer-reviewed recommendations for translating pharmacogenetic test results into actionable prescribing descisions for warfarin management. - PMC - PubMed
    1. Johnson JA, Gong L, Whirl-Carrillo M, et al. Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C9 and VKORC1 Genotypes and Warfarin Dosing. Clin Pharmacol Ther. 2011;90:625–9. - PMC - PubMed

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