Lanham Kena J, Oestreich Julie H, Dunn Steven P, Steinhubl Steven R
Pharmacy Services, UK HealthCare, University of Kentucky, Lexington, Kentucky, USA; ; Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, Kentucky, USA;
Pharmgenomics Pers Med. 2010;3:87-99. doi: 10.2147/pgpm.s9597. Epub 2010 Jun 18.
Antithrombotic therapy, including anticoagulants as well as antiplatelet drugs, is an important component in the treatment of cardiovascular disease. Variability in response to such medications, of which pharmacogenetic response is a major source, can decrease or enhance the benefits expected. This review is a comprehensive assessment of the literature published to date on the effects of genetic polymorphisms on the actions of a variety of antithrombotic medications, including warfarin, clopidogrel, prasugrel, and aspirin. Literature evaluating surrogate markers in addition to the impact of pharmacogenetics on clinical outcomes has been reviewed. The results of the studies are conflicting as to what degree pharmacogenetics will affect medication management in cardiovascular disease. Additional research is necessary to discover, characterize, and prospectively evaluate genetic and non-genetic factors that impact antithrombotic treatment in order to maximize the effectiveness and limit the harmful effects of these valuable agents.
抗血栓治疗，包括抗凝剂和抗血小板药物，是心血管疾病治疗的重要组成部分。对此类药物反应的变异性（其中药物遗传学反应是主要来源）可能会降低或增强预期疗效。本综述全面评估了迄今为止发表的关于基因多态性对多种抗血栓药物（包括华法林、氯吡格雷、普拉格雷和阿司匹林）作用影响的文献。除了药物遗传学对临床结局的影响外，还对评估替代标志物的文献进行了综述。关于药物遗传学在多大程度上会影响心血管疾病的药物管理，研究结果存在矛盾。有必要进行更多研究，以发现、表征和前瞻性评估影响抗血栓治疗的遗传和非遗传因素，从而最大限度地提高这些重要药物的有效性并限制其有害影响。
