Key result
The presence of the G allele (Glu) of the ADRB2 gene (Glu27Gln) protected against beta-blocker-induced hypotension in ACS patients (OR 0.14; 95% CI 0.03-0.60; p<0.01).
Why the study?
Beta-blockers are frequently discontinued in ACS due to adverse effects, and evidence for pharmacogenetic associations with ADRB1, ADRB2, and CYP2D6 polymorphisms is limited in ACS compared to heart failure or hypertension.
Do genetic polymorphisms in ADRB1, ADRB2, and CYP2D6 influence the risk of bradycardia or hypotension in ACS patients treated with beta-blockers?
Observational (n=285)
Do genetic polymorphisms in ADRB1, ADRB2, and CYP2D6 influence the risk of bradycardia or hypotension in ACS patients treated with beta-blockers?
Answers are grounded in this paper and cite their sources.
Polymorphisms in the ADRB2 gene (rs1042713, rs1042714) may protect against beta-blocker-induced hypotension in patients with acute coronary syndrome, potentially guiding personalized therapy.
Betablockers (BBs) are prescribed for ischaemia in patients with acute coronary syndrome (ACS). In Spain, bisoprolol and carvedilol are the most prescribed BBs, but patients often had to discontinue them due to adverse effects. Single nucleotide polymorphisms (SNPs) in ADRB1, ADRB2 and CYP2D6 genes have strong evidence of pharmacogenetic association with BBs in heart failure or hypertension, but the evidence in ACS is limited. Therefore, our study focuses on investigating how these genes influence the response to BBs in ACS patients. We analysed the association between SNPs in ADRB1 Gly389Arg (rs1801253) and Ser49Gly (rs1801252), ADRB2 Gly16Arg (rs1042713) and Glu27Gln (rs1042714), and CYP2D* 6 (*2- rs1080985, *4- rs3892097, *10 - rs1065852) and the occurrence of bradycardia/hypotension events during one year of follow-up. We performed an observational study and included 285 ACS-PCI-stent patients. A first analysis including patients treated with bisoprolol and a second analysis including patients treated with other BBs were performed. We found that the presence of the G allele (Glu) of the ADRB2 gene (rs1042714; Glu27Gln) conferred a protective effect against hypotension-induced by BBs; OR (CI 95%) = 0,14 (0,03-0,60), p < 0.01. The ADRB2 (rs1042713; Gly16Arg) GG genotype could also prevent hypotensive events; OR (CI 95%) = 0.49 (0.28-0.88), p = 0015. SNPs in ADRB1 and CYP2D6 * 2, CYP2D6 * 4 weren´t associated with primary events. The effect of CYP2D6 * 10 does not seem to be relevant for the response to BBs. According to our findings, SNPs in ADRB2 (rs1042713, rs1042714) could potentially affect the response and tolerance to BBs in ACS-patients. Further studies are necessary to clarify the impact of ADRB2 polymorphisms.
No takes yet. Share an insight, caveat, or question.
Castaño‐Amores et al. (2023) conducted an observational in Acute coronary syndrome (ACS) (n=285). ADRB2 gene polymorphisms (Glu27Gln and Gly16Arg) vs. Absence of the respective alleles/genotypes was evaluated on Occurrence of bradycardia/hypotension events (OR 0.14, 95% CI 0.03-0.60, p=< 0.01). The presence of the G allele (Glu) of the ADRB2 gene (Glu27Gln) protected against beta-blocker-induced hypotension in ACS patients (OR 0.14; 95% CI 0.03-0.60; p<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: