Coronary Artery Disease - New Insights, Novel Apprs. by A. Squeri

By A. Squeri

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These may include, for example, enzymes, transporters, cell membrane receptors, intracellular receptors or components of ion channels that contribute to the pharmacokinetics or pharmacodynamics of response to a particular drug. One of the genes identified thus far as likely to contribute to the development of simvastatin-induced myopathy and myalgia is the SLCO1B1 gene161,166. Thereby, the SLCO1B variant increases the risk of statin-induced myopathy by reducing the hepatic uptake of the statins.

Pharmacogenomics can provide important insights into the therapy of CAD and related risk factors through elucidation of the genetic (or genomic) contribution to variable response to different drugs.

Specifically, clopidogrel is a prodrug that undergoes hepatic biotransformation by CYP2C19 into its active metabolite. However, a considerable number of patients continue to experience adverse outcomes, including both bleeding and recurrent ischemic events, possibly attributable, in part at least, to the broad variability in individual response profiles to this standard antiplatelet treatment regimen172. Gene polymorphisms affecting clopidogrel metabolic bioactivation and platelet function may be responsible.

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