Patient Oriented Research in Personalized Antithrombotic Therapy

摘要 Nita Limdi，Pharm. D，PhD已经建立了一个成功的研究项目，专注于抗血栓治疗 药物基因组学包括观察和临床试验设计。她的科学事业目标 全面了解影响变异性的临床、环境和遗传因素 并利用这些信息进行个体化抗血栓治疗，特别是 患有多种合并症的患者。拟议的奖项将使她能够继续指导， 扩大她的研究，特别是纳入旨在解决关键知识差距的目标， 口服抗凝剂和抗血小板治疗。 本文提出的新研究是建立在正在进行的工作，以创造独特的和急需的病人。 在口服抗血栓治疗不断发展的背景下，提供面向研究（POR）的培训机会 并整合了药物基因组学和精准医疗的实施。NHLBI R01 资助沿着三个新项目将成为学员培训的基础。每个项目都由一个 学员项目1将阐明定义为左心室射血分数的心力衰竭的影响 (LVEF<40%）对华法林的反应。项目2：将评估临床和遗传学的影响 （候选基因）对达比加群（DBG）相关出血的影响，并建立临床预测规则， 个性化DBG用户中出血的预测。项目3：将评估 基因型导向抗血小板治疗（GGAT）对经皮冠状动脉介入术后并发症的影响 干预，并评估其临床效用和经济价值。 导师制旨在扩大医学博士、药学博士和博士学员的POR培训机会。学员 将领导新项目，进行分析并发表原创研究。他们会利用这一点提出 作为他们NIH-K23应用的一部分。 在UAB的大力支持和协作环境中，该奖项将确保Limdi博士继续 发展她的研究计划，并通过指导初级研究人员建立自己的研究计划， careers.多个机构计划的广度和深度，UAB的CTSA和她在 UAB的个性化医学研究所将提供资源和基础，以提高精度 心血管内科

Abstract Nita Limdi, Pharm.D, PhD has built a successful research program focused on antithrombotic therapy pharmacogenomics encompassing both observational and clinical trial designs. Her scientific career goals are to comprehensively understand the clinical, environmental and genetic factors that influence variability in antithrombotic response and to use this information to personalize antithrombotic treatment, especially in patients with multiple comorbidities. The proposed award would enable her to continue mentoring while augmenting her research, specifically incorporating aims built to address key knowledge gaps regarding the oral anticoagulant and antiplatelet therapy. The new research proposed herein is builds on ongoing work to create unique and much needed patient oriented research (POR) training opportunities within the evolving landscape of oral antithrombotic therapy and integrates pharmacogenomics and implementation of precision medicine. The candidate's NHLBI R01 grant along with the three new projects will form the basis for the mentee training. Each project is led by a mentee. PROJECT1 will elucidate the influence of heart failure as defined as left ventricular ejection fraction (LVEF <40%) on warfarin response. PROJECT 2: will evaluate the influence of clinical and genetic (candidate genes) on Dabigatran (DBG) related hemorrhage and build clinical prediction rules to personalize the prediction of hemorrhage among DBG users. PROJECT 3: will evaluate the effectiveness of genotype-guided antiplatelet therapy (GGAT) on complications following percutaneous coronary intervention and assess its clinical utility and economic value. Mentorship aims expanding the POR training opportunities for MD, Pharm.D, and PhD trainees. Mentees will lead the new projects, conduct analysis and publish original research. They will leverage this to propose new research as part of their NIH- K23 applications. In the strongly supportive and collaborative environment of UAB, this award will ensure Dr. Limdi continues to grow her research program, and build capacity in POR by mentoring junior investigators to build their own careers. The breadth and depth of the multiple institutional programs, UAB's CTSA and her leadership in UAB's Personalized Medicine Institute will provide the resources and the foundation to advance precision cardiovascular medicine.