Pharmacogenetics of the Response to Statins

摘要

Statins (inhibitors of the enzyme 3-hydroxy-3methylglutaryl-coenzyme A reductase) are widely prescribed medications for the prevention of incident and recurrent cardiovascular disease events and death. They are powerful assets in the current arsenal of cardiovascular medications, with high efficacy and minimal toxicity. However, heterogeneity exists with respect to the response to statin medications, and there has been considerable investigation into the genetic determinants of the statin response. In this review, we separate the response to statins into 1) measures of efficacy (low-density lipoprotein cholesterol lowering and protection from cardiovascular events) and 2) effects of toxicity (musculoskeletal adverse effects and nonadherence to statin therapy). The current data suggest that prospective genotyping for certain variants may be of use in tailoring statin therapy to reduce cardiovascular events and to avoid statin-induced adverse effects.