Institute of Clinical Chemistry and Laboratory Medicine, Medical Center - University of Freiburg, Hugstetter Straße 55, D-79106, Freiburg, Germany.
Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Curr Cardiol Rep. 2018 May 25;20(7):56. doi: 10.1007/s11886-018-0996-5.
Today, statins are the first choice to lower LDL cholesterol and concomitantly the risk of atherosclerotic cardiovascular disease. There is a significant minority of statin-treated patients who are more susceptible to occasionally serious side effects that may increase morbidity and lead to compliance problems or the discontinuation of therapy. This review addresses the question of whether genetics can provide meaningful insights into the risk of statin side effects or therapy success.
The use of genome-wide association studies has significantly reduced the number of predictive genetic markers for statin effects, and the isolated effect of the surviving markers is low; more promising are approaches to stratify patients with genetic risk scores. Patients reveal a pronounced individual response to the administration of statins. The idea of being able to adequately describe this variability with single genetic markers has failed, genetic risk scores will be the method of choice.
目前,他汀类药物是降低 LDL 胆固醇和降低动脉粥样硬化性心血管疾病风险的首选药物。有一小部分他汀类药物治疗的患者更容易偶尔出现严重的副作用,这可能会增加发病率,并导致依从性问题或治疗中断。本综述探讨了遗传因素是否能为他汀类药物副作用或治疗效果的风险提供有意义的见解。
全基因组关联研究大大减少了预测他汀类药物作用的遗传标记物数量,幸存标记物的单独作用较低;更有前途的方法是对具有遗传风险评分的患者进行分层。患者对他汀类药物的给药反应明显不同。用单个遗传标记物充分描述这种变异性的想法已经失败,遗传风险评分将是首选方法。