Racial and ethnic differences in pharmacotherapy to prevent coronary artery disease and thrombotic events.
Eur Heart J Cardiovasc Pharmacother
; 8(7): 738-751, 2022 Sep 29.
Article
Dans Anglais
| MEDLINE | ID: covidwho-2326576
ABSTRACT
Awareness of racial/ethnic disparities represents a key challenge for healthcare systems that attempt to provide effective healthcare and to reduce existing inequalities in the use of and adherence to guideline-recommended cardiovascular drugs to improve clinical outcomes for cardiovascular disease (CVD). In this review, we describe important racial/ethnic differences between and within ethnic groups in the prevalence, risk factors, haemostatic factors, anti-inflammatory and endothelial markers, recurrence, and outcomes of CVD. We discuss important differences in the selection, doses, and response [efficacy and adverse drug reactions (ADRs)] in ethnically diverse patients treated with antithrombotics or lipid-lowering drugs. Differences in drug response are mainly related to racial/ethnic differences in the frequency of polymorphisms in genes encoding drug-metabolizing enzymes (DMEs) and drug transporters. These polymorphisms markedly influence the pharmacokinetics, dose requirements, and safety of warfarin, clopidogrel, and statins. This review aims to support a better understanding of the genetic differences between and among populations to identify patients who may experience an ADR or a lack of drug response, thus optimizing therapy and improving outcomes. The greater the understanding of the differences in the genetic variants of DMEs and transporters that determine the differences in the exposure, efficacy, and safety of cardiovascular drugs between races/ethnicities, the greater the probability that personalized medicine will become a reality.
Mots clés
Texte intégral:
Disponible
Collection:
Bases de données internationales
Base de données:
MEDLINE
Sujet Principal:
Maladie des artères coronaires
/
Hémostatiques
/
Agents cardiovasculaires
/
Maladies cardiovasculaires
/
Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase
Type d'étude:
Études expérimentales
/
Étude observationnelle
/
Étude pronostique
/
Essai contrôlé randomisé
Les sujets:
Variantes
Limites du sujet:
Humains
langue:
Anglais
Revue:
Eur Heart J Cardiovasc Pharmacother
Année:
2022
Type de document:
Article
Pays d'affiliation:
Ehjcvp
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