Genetic tailoring of pharmacotherapy in heart failure: optimize the old, while we wait for something new
Journal of Cardiac Failure, 04/17/2012

Talameh JA et al. – The heart failure (HF) pharmacogenetic literature is still in its very early stages, but there are promising candidate genetic variants that may identify which HF patients are most likely to benefit from beta–blockers and angiotensin–converting enzyme (ACE) inhibitors and patients that may require additional therapies.

• Beta–blocker and ACE inhibitor pharmacogenetic studies performed in patients with HF were identified from the Pubmed database from 1966 to July 2011.
• Thirty beta–blocker and 10 ACE inhibitor pharmacogenetic studies in patients with HF were identified.
• The ACE deletion variant was associated with greater survival benefit from ACE inhibitors and beta–blockers compared with the ACE insertion.

• Ser49 in the beta–1 adrenergic receptor, the insertion in the alpha–2C adrenergic receptor, and Gln41 in G–protein–coupled receptor kinase 5 are associated with greater survival benefit from beta–blockers, compared with Gly49, the deletion, and Leu41, respectively.
• However, many of these associations have not been validated.