Millions of Americans currently take cardiovascular medications to treat or prevent heart disease. Major pharmacogenetic strides over the past decade have led the way to leveraging genetic information to guide therapies for cardiovascular patients.
Other genetic pathways include CYP2C9, CYP3A4, CYP3A5, VKORC1, F2/Factor II, F5/Factor V Leiden, and SLCO1B1. Your genes are the main factor determining the level of these enzymes primarily found in your liver. If you have too much of the enzyme, you process the medication too quickly: too little of the enzyme and the medication builds up in your bloodstream, potentially causing adverse reactions or side effects.
Population Frequency of Cytochrome P450 (CYP) Metabolizer Types [5]
| Poor (no or low enzyme levels) |
Intermediate (reduced enzyme levels) |
normal (normal enzyme levels) |
Rapid or Ultra Rapid Metabolizer (high enzyme levels) |
|
|---|---|---|---|---|
| CYP2D6* | 4-7% | 9-35% | 50-90% | 2-3% |
| CYP2C9 | 3% | 30% | 68% | N/A |
| CYP2C19* | 2-20% | 24-36% | 14-44% | 30% |
*CYP2C19 variability depends on ethnicity.
*CYP2D6 Variability depends on ethnicity and classification of Intermediate activity
Additional heart disease medications that are impacted by your genetics:[15]
| Trade Name | Drug |
|---|---|
| Brilinta® | ticagrelor |
| Coreg® | carvedilol |
| Coumadin®, Jantoven® | warfarin |
| Crestor® | rosuvastatin |
| Effient® | prasugrel |
| Inderal®, InnoPran®, Hemangeol® | propranolol |
| Lopressor®, Toprol® | metoprolol |
| Plavix® | clopidogrel |
| Rythmol® | propafenone |