Genomic prediction of individual drug response

A novel medical approach, personalized medicine, seeks to use genetic information to “personalize” and improve diagnosis, prevention and therapy. The personalized management of cardiovascular disease involves a large spectrum of potential applications, from diagnostics of monogenic disorders, to prevention and management strategies based on modifier genes, to pharmacogenomics. Several lines of evidence suggest that common polymorphic variants of modifier genes can influence the response to drug response in cardiovascular disease. Using pharmacogenomics approaches to affect management of heart failure, arrhythmias, dyslipidemia and hypertension, warfarin anticoagulation and antiplatelet therapy appears very promising. In heart failure, common genetic variants of beta-adrenergic receptors, alpha-adrenergic receptors and endothelin receptors among others significantly alter the response to heart failure therapy. This knowledge could be used to personalize and optimize cardiovascular therapy based on the patient’s genetic profile. While the advances in technologies will continue to transition personalized medicine from the research to the clinical setting, physicians and in particular cardiologists need to reshape clinical diagnostics paradigms, learn how to use new genomic information to change management decisions, and provide the patients with appropriate education and management recommendations.