Аңдатпа
Background. Prescription of dangerous and undesirable drug combinations occurs in healthcare systems of most countries worldwide. Among drugs with the highest risk in such combinations, statins are considered particularly hazardous due to their significant metabolic activity. In the healthcare system of Kazakhstan, this problem remains poorly studied, and the structure of genetic predisposition to adverse effects is unknown. Objective. To determine the frequency of SLCO1B1 gene polymorphism in patients with coronary artery disease of the Kazakh population of East Kazakhstan and its association with the efficacy and safety of atorvastatin therapy. Methods. A cross-sectional clinical-genetic study was conducted. The study did not involve any active intervention in the ongoing treatment of patients prescribed by physicians. Medical records containing prescription data from inpatient and outpatient settings were analysed. The presence of SLCO1B1 (c. 521T>C) polymorphisms of the OATP1B1 transporter protein was assessed. Results. The study included 178 individuals (108 men and 70 women) aged 40 to 70 years (mean age 61.1±7.8 years). All patients were of Kazakh ethnicity. In the examined group of patients receiving statin therapy, a significant frequency of genetic variants associated with an increased risk of statin-related complications was identified. Significant differences in the frequency of clinical manifestations of drug-induced muscle adverse effects were observed for the SLCO1B1 gene in carriers of the homozygous CC genotype (χ² = 23.31, p < 0.001). A marked increase in creatine phosphokinase activity (3.39-fold, p < 0.001) and a reduction in atorvastatin efficacy were also observed. Conclusions. In the studied Kazakh population, analysis of the SLCO1B1 (c. 521T>C) polymorphism can be recommended as a genetic marker of the risk of adverse reactions during lipid-lowering therapy with statins (atorvastatin), as this polymorphism reduces treatment efficacy and increases the risk of side effects.