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Ann Thorac Surg 2003;76:S2246-S2253
© 2003 The Society of Thoracic Surgeons

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Supplement: Gibbon & His Heart-Lung Machine

The emerging role of pharmacogenomics in the treatment of patients with heart failure

^a Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania, USA

^* Address reprint requests to Dr Feldman, Department of Medicine, Jefferson Medical College, 1025 Walnut St, Room 822, Philadelphia, PA 19107-5083, USA
e-mail: Arthur.feldman@mail.tju.edu

Presented at the symposium, "Gibbon & His Heart-Lung Machine: 50 Years & Beyond," Philadelphia, PA, May 2, 2003.

The first 300 words of the full text of this article appear below.

Heart failure is a disease of epidemic proportions effecting more than 5 million people in the United States. It accounts for more than 1 million hospitalizations, represents the most common discharge diagnosis of patients over the age of 65, and is one of only a handful of human diseases that are increasing in frequency. The increase in frequency of heart failure is due at least in part to the aging of the US population. It is expected that more than 450,000 new cases will be recognized in the coming year and nearly an equal number of deaths will occur that are directly attributable to heart failure. Inclusive of both inpatient and outpatient costs, the care for heart failure will cost the US economy nearly 30 billion dollars in 2003.

Over the past 2 decades seminal information regarding the pathophysiology of heart failure has come from evaluation of the results of large multicenter, randomized, placebo-controlled clinical trials. These studies have validated the use of both angiotensin-converting enzyme (ACE) inhibitors and beta adrenergic-receptor blockers (ß-blockers) in the therapy of heart failure, findings that have resulted in improvements in both morbidity and mortality. However two fundamental observations have come from heart failure clinical trials: only some patients respond to a given drug; and different patients respond differently to the same drug. This variability in pharmacologic response provides important relevance to heart failure patients, many of whom take as many as nine medications. Identifying which drugs benefit selected patients can obviate adverse drug effects; decrease the total number of medications consumed by individual patients; decrease pharmaceutical costs; improve compliances; and provide an opportunity to optimize the dosing of those drugs that will be most effective.

The fact that selective patient groups respond differently to a pharmacologic agent could be explained by either their phenotype . . . [Full Text of this Article]

This article has been cited by other articles:

				I. Cascorbi, M. Paul, and H. K. Kroemer Pharmacogenomics of heart failure - focus on drug disposition and action Cardiovasc Res, October 1, 2004; 64(1): 32 - 39. [Abstract] [Full Text] [PDF]