The Role of Pharmacogenomics in Drug-Induced Cardiovascular Toxicity

Drug-induced cardiovascular toxicity is a very serious problem in clinical medicine. It can be characterized by damage to the myocardium and vasculature like myocardial ischemia, arrhythmia, heart failure or changes in hemodynamics and deterioration of blood coagulation. This type of cardiovascular toxicity is a dose-dependent adverse effect that has substantial impact on patients’ morbidity and mortality and brings additional social and economic burden. The identification of genetic variants associated with an increased risk of drug-induced cardiovascular toxicity has the potential to improve patient care. Pharmacogenomics, as a new area of pharmacotherapy, investigating how individual genetic variations, alone or in combination with polygenic risk factors, brings about information that can impact drug metabolism, efficacy or toxicity. By examining the single gene interactions with drugs, the aim of pharmacogenomic studies is to optimize drug therapy in order to ensure maximum efficacy with minimal adverse effects. The identification of genetic basis as the underlying mechanisms of drug-induced cardiovascular toxicity can provide valuable insights of its pathophysiology. This chapter brings an overview of genetic variations associated with the risk of drug-induced cardiovascular toxicity.