Clinical application of genetic in stroke
Genetics in stroke can be considered in the following aspects: stroke in the course of inherited disorders, genetic risk factors of stroke and pharmacogenetics of stroke treatment and prevention. Although less than 1% of stroke cases are inherited, the ability to establish genetic diagnosis prevents such cases from exposure to unnecessary and potentially harmful therapeutic agents and diagnostic tests, allows introducing specific effective treatment and allows planning rational family counseling. The candidate gene approach is the most common way to study the significance of chosen genetic variants as risk factors of stroke. Unfortunately, only few genetic variants were shown to affect stroke risk in the independent replication studies. A novel approach, genome wide association studies, use the markers evenly spaced throughout genome without regard to their function or location and allows to find all genetic variants related to the disease. Because available data suggest that the effect on stroke risk is related to many genetic variants with small effect size, large number of cases and controls are required to find such risk variants. The up-data of international effort to find out genetic variants related to stroke risk will be discussed. Increasing data indicate that several genetic factors may determine response to stroke treatment by rtPA and its prevention by aspirin, clopidogrel, warfarin, statins and antihypertensive drugs. The perspective for the future of stroke genetics is the era of personalized prevention and therapy, where specific biochips will help stroke clinicians to decide on the best individual prevention program and treatment.
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