The impact of molecular medicine upon early cardiovascular drug development

摘要: Heart disease remains the leading cause of death and morbidity in western world despite significant advances cardiovascular (CVS) therapeutics. Since 1960s clinical pharmacologists have been very much involved bringing forward new classes CVS drugs. This started with introduction β-adrenoceptor blockers early has continued calcium antagonists, ACE inhibitors more recently endothelin antagonists. The principles for classical drug design based upon interaction with: receptor sites (β-adreno-ceptor blockers), enzymes (thrombolytics anticoagulants) ion channels (calcium antiarrhythmics). advent molecular biology added a fourth principle development – that While approaches will still provide drugs (e.g. platelet IIb/IIIa antagonists directly acting thrombin inhibitors), there is now anticipation therapeutics specific means intervention thus potentially avoiding some problems associated non specificity conventional approaches, e.g. side-effects lack cardioselectivity blockers, risk bleeding anticoagulants, cough inhibitors, controversy following retrospective analysis use antagonists. In broader sense includes both gene therapy oligonucleotide therapy. However genetic (identification polymorphisms diseases) mean may be further impact namely known to select patient populations at risk. We review status each these prospects future.