Medical Chronicle November/December 2013 | Page 24

CARDIAC
Genetic variation and response to statins
The Heart Protection Study was a
large study on >20 000 people who
were at high risk for cardiovascular disease. They were randomly given 40mg
of simvastatin or matching placebo for
five years.
A prespecified objective was to
investigate the association of common
genetic variants with the response to
statin therapy. It included genome-wide
association analysis of the LDL-cho-

lesterol and Apolipoprotein-B (ApoB)
responses to 40mg of simvastatin.

Methods
During the original study, blood samples
were taken from patients participating
in the trial for the evaluation of genetic
variations. A genome-wide study of the
LDL-cholesterol and ApoB response to
40mg simvastatin was performed in
3895 patients, and the nine strongest

associations were tested in 14 810 additional patients. Selected genes were
tested in 18 705 patients.

Results
There were no significant associations
in the genome-wide study, nor were
there any significant associations of the
tested genes in response to the statin.
More importantly, there were no differences in the risk reduction of major

cardiovascular events among the different genetic variations (genotyp W2??6??6?W6???0???6?????vV?WF?2f&??G2F????B6?v??f?6?F??FW"F?R??@?&W7??6RF?7FF??F?W&?0?FV???7G&FVB??F?RfW'??&vP?6???6?G&??F?R?V'B&?FV7F????7GVG???"??F?W&RvW&R6???"?&vR&VGV7F???2??f67V?"&?6?v?F?6??f7FF???'&W7V7F?fR?bvV??G?W0?76?6?FVBv?F?F?R??B&W7??6P?F?F?R7FF????2??BF??27FvRF?Rf?VR?bvV??G?W2????f?&??r6???6?FV6?6???2F?????6R7FF??F?W&??V'2F?&R??FVB??&VfW&V?6W2f??&?R??&WVW7B?4???T?@?&VGV6??p?6&F??f67V? ?WfV?G0??7?7F??2&???B&W77W&R?2F?R????f?&??b??W'FV?6???gFW"F?RvR?`?S?V'2?B?26?v??f?6?B??7@???6&F??f67V?"F?6V6R?7F?ffV???p??bF?R'FW&?W2v?F???7&V6??rvP?FV?G2F?V?WfFR7?7F??2&???B&W77W&R?v???RF?7F??2&???B&W77W&P?&V???2Ó??r?6??F?F????`??6??FVB7?7F??2??W'FV?6????FF?g&??6???6?G&??2?fR6??f??6??v??FV???7G&FVBF?BF?W&?F?&VGV6P?7?7F??2&???B&W77W&R6?v??f?6?F??&VGV6W26&F??f67V?"WfV?G2?F?P???vW"F?R&???B&W77W&R?F?R??vW ?F?R&?6??b7G&??R?'WBv?F???r?WfV?0??b&???B&W77W&R??G&VF?V?B?F?P?&?6??b??6&F????f&7F??????7GV??&?6R??WrwV?FV??W2FVf??P?F?ffW&V?B&???B&W77W&R?WfV?2??wV?FV??W2f?"F?RW6R?b7FF???F?W&??2&VV?&6VB??F?P?6?7V?F????b'6??WFR&?6?W6??r?&?6?6?7V?F?"7V6?2g&??v?????&wV?V?B?2??r?FRF?BF?W&P?&RV??Vv?&?'W7B6???6?G&??FF?F?W6RFFF?FWFW&??Rv???VVG0?7FF?????F?R?&vR?V'B&?FV7F???7GVG??b??F?V?G2??Bv0?6??v?F?B6?????vV?WF?2f&?F???2F???B??f?VV?6RF?R&W7??6P?F???B??vW&??r?bF?R7FF????? ?F?W2?BffV7BF?R6&F??f67V?"&VGV7F???6VV?v?F?6??f7FF???v??6??v2F?R7FF??W6VB??F?R7GVG??BF?W2??B6VV?BF??27FvRF?@?vV?WF?2f7F?'2v?????f?VV?6P?F?RVff?67??b7FF??F?W&???#B?TD?4?4?$???4?R??dT?$U"?DT4T?$U"#0????4DVwW7C#2???FB??r?#2?2?#???