Laboratory Medicine in the Clinical Decision Support for Treatment of Hypercholesterolemia: Pharmacogenetics of Statins

Clin Lab Med. 2016 Sep;36(3):473-91. doi: 10.1016/j.cll.2016.05.010. Epub 2016 Jun 24.

Abstract

Statin responsiveness is an area of great research interest given the success of the drug class in the treatment of hypercholesterolemia and in primary and secondary prevention of cardiovascular disease. Interrogation of the patient's genome for gene variants will eventually guide anti-hyperlipidemic intervention. In this review, we discuss methodological approaches to discover genetic markers predictive of class-wide and drug-specific statin efficacy and safety. Notable pharmacogenetic findings are summarized from hypothesis-free genome wide and hypothesis-led candidate gene association studies. Physiogenomic models and clinical decision support systems will be required for DNA-guided statin therapy to reach practical use in medicine.

Trial registration: ClinicalTrials.gov NCT00767130.

Keywords: Coenzyme Q(10); Lipid metabolism; Myalgia; Myopathy; PCSK9 inhibitors; Pharmacogenetics; Physiogenomics; Statins.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / prevention & control*
  • Decision Support Systems, Clinical
  • Genotype
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / drug therapy*
  • Hypercholesterolemia / genetics*
  • Laboratories
  • Pharmacogenomic Variants*
  • Phenotype
  • Primary Prevention
  • Secondary Prevention

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors

Associated data

  • ClinicalTrials.gov/NCT00767130