Numerous drugs are associated with adverse cardiovascular events. Even nonsteroidal anti-inflammatory medications, generally well-tolerated in most patients, can lead to cardiovascular issues. Cardiovascular disease stands as the primary cause of death for most groups in the UK and contributes to one in four deaths. The urgency to anticipate drug-related cardiovascular events is evident.
Pharmacogenomics (PGx) may have a crucial role in mitigating the risk of drug-related cardiovascular issues. A study conducted in 2018 examined the impact of loss-of-function CYP2C19 alleles on antiplatelet therapy. Researchers monitored 1,815 patients post-percutaneous coronary intervention for coronary artery disease. Among the participants, 572 (31.5 percent) possessed a loss-of-function allele.
The risk of a major cardiovascular episode was significantly higher in the loss-of-function group when administered clopidogrel. However, those treated with prasugrel or ticagrelor had a considerably lower risk of a cardiovascular episode. This underscores the significance of genetic testing in identifying viable alternatives to primary treatments.
Warfarin, a blood thinner that can be toxic in high doses, contributes to more drug-related emergency room visits among older patients than any other prescription drug. Nevertheless, this crucial anticoagulant can also reduce the risk of life-threatening blood clots, especially in immobilized patients with cardiovascular risk factors.
A randomized clinical trial in 2017 compared outcomes in 1,650 patients who underwent elective knee or hip arthroplasty at one of six medical centers. The average age was 72.1 years, and patients took warfarin to prevent blood clots. Warfarin dosing guided by PGx, rather than clinical recommendations, resulted in a reduced risk of major bleeding, blood clots, venous thromboembolism, and death.