Genetic background of coronary artery disease: clinical implications and perspectives

ABSTRACT Introduction Both genetic background and life-style factors influence coronary artery disease (CAD) individual risk and clinical manifestations. Areas covered Over the last decades, cardiovascular disease (CVD) emerged as the most important cause of morbidity and mortality worldwide, leading the scientific community to nourish increased interest in cardiovascular risk factors control. Several cohort studies have shown that a family history of ischemic heart disease is common among patients suffering from CAD, suggesting that genetic factors play a role of utmost relevance. The techniques used to study the genetic basis of these diseases have evolved from linkage studies to candidate gene studies and genome-wide association studies (GWAS). Linkage studies have been able to identify genetic variants associated with monogenic diseases, whereas genome-wide association studies have been more successful in determining genetic variants associated with complex diseases. However, family context transmits not only genetic information, but also attitudes and lifestyle habits which proved to significantly influence the overall cardiovascular risk. Expert opinion In the era of patient-tailored management, the aim of this review is to summarize the genetic background of patients with CAD, focusing on the most updated gene-targeted therapies, providing potential future perspectives of pharmacogenetics utility in daily clinical practice.