NEW YORK (Reuters Health) - The B2 allele of the cholesteryl ester transfer protein (CETP) Taq1b gene polymorphism appears to substantially reduce the incidence of cardiovascular events in carriers receiving statin therapy, researchers report in the December issue of the American Heart Journal.
As lead investigator Dr. John F. Carlquist told Reuters Health, “the goal of pharmacogenetics is to identify those individuals who will receive maximum benefit from a drug as well as those who may not respond or respond adversely. Although preliminary, our results suggest that genetic tests may emerge that identify those most likely to benefit from statin therapy.”
Dr. Carlquist of the University of Utah School of Medicine, Salt Lake City, and colleagues note that the CETP gene is involved in the regulation of plasma lipid distribution and that the Taq1B polymorphism may influence cardiovascular effects via an impact on plasma HDL concentrations, atherosclerosis progression and other factors.
To investigate, the researchers genotyped and prospectively followed 2531 patients who had significant coronary artery disease and were undergoing coronary arteriography.
Those who were carriers of the CETP Taq1B polymorphisms B1B1, B1B2, and B2B2 showed a similar reduced level of plasma HDL and, overall, cardiovascular event rates did not differ among genotypes.
Furthermore, event rates did not differ between B1 homozygotes taking or not taking statins (24.2% versus 24.8%). However, statins significantly reduced events in B1B2 subjects (21% versus 28%) and in B2B2 subjects (17.4% versus 26.4%).
In light of these and other findings, the researchers conclude that CETP Taq1B genotyping has the potential “to enable more effective pharmacogenetically directed therapy.”
In an accompanying editorial, Drs. Elizabeth R. Hauser and Andrew S. Allen of Duke University Medical Center, Durham, North Carolina, observe that anyone trying to replicate these results will need a sample size four times larger than that presented in order to “obtain a reasonable power over a wide spectrum of allele frequencies.”
Nevertheless, they do point out that “these are exciting times for the study of gene-environment interactions of any kind, with pharmacogenetics leading the way.”
Source: Am J Heart 2003;146:1007-1014. [ Google search on this article ]
MeSH Headings:Biological Sciences: Biology: Genetics: Pharmacogenetics: Polymorphism, Restriction Fragment Length: Taq Polymerase: Biological SciencesCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
