Assuntos
Dislipidemias/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Transporte Biológico , Colesterol/sangue , Proteínas de Transferência de Ésteres de Colesterol/antagonistas & inibidores , HDL-Colesterol/administração & dosagem , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Suplementos Nutricionais , Dislipidemias/sangue , Mutação com Ganho de Função , Humanos , Hipolipemiantes/farmacologia , Receptores X do Fígado/agonistas , Niacina/uso terapêutico , Oligorribonucleotídeos Antissenso/uso terapêutico , Inibidores de PCSK9 , Pró-Proteína Convertase 9/sangue , Pró-Proteína Convertase 9/genética , Proteínas Recombinantes/administração & dosagemRESUMO
The field of genetics and genomics has advanced considerably with the achievement of recent milestones encompassing the identification of many loci for cardiovascular disease and variable drug responses. Despite this achievement, a gap exists in the understanding and advancement to meaningful translation that directly affects disease prevention and clinical care. The purpose of this scientific statement is to address the gap between genetic discoveries and their practical application to cardiovascular clinical care. In brief, this scientific statement assesses the current timeline for effective translation of basic discoveries to clinical advances, highlighting past successes. Current discoveries in the area of genetics and genomics are covered next, followed by future expectations, tools, and competencies for achieving the goal of improving clinical care.
Assuntos
Doenças Cardiovasculares/genética , Genômica , Pesquisa Translacional Biomédica/tendências , American Heart Association , Animais , Biotransformação/genética , Fármacos Cardiovasculares/farmacocinética , Fármacos Cardiovasculares/uso terapêutico , Avaliação Pré-Clínica de Medicamentos/métodos , Previsões , Variação Genética , Projeto Genoma Humano , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hiperlipoproteinemia Tipo II/tratamento farmacológico , Células-Tronco Pluripotentes Induzidas , Camundongos , Terapia de Alvo Molecular , Pesquisa Translacional Biomédica/economia , Pesquisa Translacional Biomédica/organização & administração , Estados UnidosRESUMO
Although statins have demonstrated consistent and strong effects on cardiovascular prevention, non-statin drugs have failed to show additional clinical benefit. Consequently, statins are currently recommended as first-line therapy in dyslipidemia. On the contrary, non-statin drugs are indicated in limited cases in which statins are not sufficiently effective or intolerable. A recent trial on ezetimibe provides evidence supporting further prescription of this agent. Proprotein convertase subtilisin-kexin type 9 inhibitors have strong low-density lipoprotein-cholesterol-lowering effects and were just approved in Western countries. However, results of clinical outcomes are not yet available. Other non-statin lipid-modifying agents have their own roles and limitations. Thus, it is important to have correct knowledge on these agents for optimal treatment of dyslipidemic patients.