Precision Medicine and Adverse Drug Reactions Related to Cardiovascular Drugs.
Precision Medicine and Adverse Drug Reactions Related to Cardiovascular Drugs.
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DOI：
10.3390/diseases9030055
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发表时间：
2021-08-12
期刊：
影响因子：
--
通讯作者：
Lang CC
中科院分区：
文献类型：
--
作者：
Noyes JD;Mordi IR;Doney AS;Jamal R;Lang CC
心血管疾病仍然是全球主要的死亡原因。早期干预，加上生活方式建议和适当的医疗治疗，是降低高危人群患者死亡率的根本。对于那些与心血管疾病的日常挑战生活在一起的人来说，药物管理的目的是缓解症状和防止疾病进展。尽管尽了最大努力，处方药也不是没有不良影响，这可能会导致严重的患者发病率和相应的医疗保健系统经济负担。心血管疾病患者往往是最容易出现药物不良反应的患者之一，因为他们合并多种疾病和高龄。检查患者的基因组以评估可能改变药物疗效和对不良反应易感性的变异是药物基因组学的基础。这一策略正越来越多地应用于临床心脏病学，以量身定做患者的治疗方法。识别与药物不良反应相关的特定变种的目的是预测哪些人具有最大的伤害风险，从而能够提供替代疗法。这篇综述将探索目前可用于基于药物基因组的处方的指导，以及探索实施遗传风险评分以量身定制治疗的可能性。将讨论大型数据库和电子健康记录的好处，以帮助促进药物基因组学与初级保健的整合，初级保健是处方的核心地带。
Cardiovascular disease remains the leading global cause of death. Early intervention, with lifestyle advice alongside appropriate medical therapies, is fundamental to reduce patient mortality among high-risk individuals. For those who live with the daily challenges of cardiovascular disease, pharmacological management aims to relieve symptoms and prevent disease progression. Despite best efforts, prescription drugs are not without their adverse effects, which can cause significant patient morbidity and consequential economic burden for healthcare systems. Patients with cardiovascular diseases are often among the most vulnerable to adverse drug reactions due to multiple co-morbidities and advanced age. Examining a patient’s genome to assess for variants that may alter drug efficacy and susceptibility to adverse reactions underpins pharmacogenomics. This strategy is increasingly being implemented in clinical cardiology to tailor patient therapies. The identification of specific variants associated with adverse drug effects aims to predict those at greatest risk of harm, allowing alternative therapies to be given. This review will explore current guidance available for pharmacogenomic-based prescribing as well as exploring the potential implementation of genetic risk scores to tailor treatment. The benefits of large databases and electronic health records will be discussed to help facilitate the integration of pharmacogenomics into primary care, the heartland of prescribing.
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