Pharmacogenomic Importance of Pravastatin

Abstract

In developed countries, cardiovascular disease is one of the leading causes of death. Among other statins, pravastatin is abundantly prescribed to reduce risk of coronary artery disease by lowering cholesterol. Genetic factors are thought to be partly responsible for the interindividual variation in the response to pravastatin. This article reviews the most important studies conducted on the pharmacogenetics of pravastatin. Currently there is no evidence to advocate pharmacogenetic testing before initiating therapy.

When statin therapy stops: implications for the patient

“…The adjusted 1-year mortality rate was higher in patients who filled some vs. all (OR 1.44; 95% CI 1. 15 P ¼ 0.001) and even higher in those who filled none vs. all (OR 1.80; 95% CI 1.35-2.42, P < 0.0001) of their discharge medications. Younger age, low-income status, having a cardiologist as the most responsible physician, documentation of receipt of discharge medication counselling, and a lower number of prescriptions before AMI were found to be significant factors for filling all prescriptions vs. none [50 ].…”

“…In patients who were adherent to aspirin, but not to statins, this beneficial effect was not noted (RR 0.91; 95% CI 0.72-1. 15), suggesting that the healthy behaviour associated with adhering to medication was not responsible for the lower recurrence [54 ]. Similarly, Rasmussen et al [21] found earlier that mortality was greatest for people with low adherence to statins (<40% PDC) when compared with high adherence (>80% PDC) (adjusted hazard ratio 1.25; 95% CI 1.09-1.42; P ¼ 0.001); this effect was not shown with adherence to calcium channel blockers.…”

“…Statins (HMG CoA reductase inhibitors) have well established beneficial effects in reducing cardiovascular risk, and statin treatment is clearly indicated in CVD guidelines [1-3]. More specifically, statins significantly decrease low-density lipoprotein cholesterol (LDL-C) and beneficially affect outcomes (including cardiovascular mortality, all-cause mortality, cardiovascular events, and revascularization) in different patient groups; these effects have been reviewed extensively recently [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. However, patients do not always adhere to their medication, and statin compliance is low in clinical practice.…”

<p>Effect of pravastatin treatment on circulating adiponectin: a meta-analysis of randomized controlled trials</p>

“…Pravastatin is a representative medication belonging to the class of 3-hydroxy-3-methylglutaryl coenzyme reductase inhibitors. 1 Similar to other statins, pravastatin is proved to be effective for the primary and secondary prevention of cardiovascular diseases (CVDs), 2,3 mainly depending on its lowering effect on low-density lipoprotein cholesterol. Different from other statins, pravastatin is suggested to be of a favorable influence on glucose metabolism and better safety profiles.…”