CardioPharmaGENET COST Action network aims to advance personalized medicine in cardiovascular care by leveraging pharmacogenomics (PGx) to optimize drug therapies. In cardiovascular medicine, this approach is especially critical, given the significant patient variability in drug responses to therapies. The main goal is to establish a pan-European network that addresses several key challenges that hinder the widespread adoption of PGx in cardiovascular care. These challenges include the lack of a centralized knowledge hub for clinicians and policymakers, insufficient integration of PGx into clinical practice, and inconsistent policy frameworks across Europe. The project also seeks to utilize AI and machine learning to streamline the analysis of large-scale genomic data and enhance clinical decision-making. The network includes five working groups (WG) to tackle these issues: WG1 evaluates the current landscape of cardiovascular PGx, identifying key gaps in research, clinical integration, and available resources; WG2 develops optimized guidelines for applying PGx in cardiovascular therapies, focusing on patient stratification based on genetic and demographic profiles; WG3 focuses on advancing digital and AI tools to improve PGx data analysis and implementation in clinical settings; WG4 analyzes regulatory frameworks across Europe, proposing policy changes to facilitate seamless integration of PGx into healthcare systems; WG5 handles communication, dissemination, and stakeholder engagement, ensuring that findings and guidelines are accessible to all stakeholders, including clinicians, researchers, and policymakers. By addressing these challenges, the network will help bridge the gap between PGx research and clinical practice, improving cardiovascular patient outcomes and promoting equitable healthcare access across Europe. This manuscript represents the COST Association-approved Memorandum of Understanding of COST Action CA24165 CardioPharmaGENET.

Background Pharmacogenomics-guided prescribing uses patient genetic information to individualize drug selection and dosing and has attracted interest as a strategy to improve outcomes and reduce adverse drug events in cardiovascular diseases. Several systematic reviews have examined its cost-effectiveness, but their findings have not been synthesized across drug classes and healthcare settings. Objective To identify, critically appraise, and synthesize findings from systematic reviews evaluating cost-effectiveness or cost-utility of pharmacogenomics-guided treatment of cardiovascular diseases. Methods This systematic review of systematic reviews was pre-registered in PROSPERO (CRD420261281565). Five databases were searched from inception, without language restrictions. Eligible studies were systematic reviews that summarized cost-effectiveness evidence on pharmacogenomics-guided cardiovascular drug prescribing. Risk of bias was assessed using ROBIS and methodological quality using AMSTAR 2. Findings were synthesized narratively. Results Ten systematic reviews (2010–2024) were included, encompassing 149 unique primary cost-effectiveness studies. The corrected covered area across reviews was 9.47% (moderate overlap). Most evidence was derived from economic modelling studies and substantial heterogeneity was observed across drug–gene pairs, comparators, and healthcare settings. CYP2C19-guided clopidogrel therapy was frequently reported as cost-effective or cost-saving, although results were less favourable when universal ticagrelor served as comparator. Evidence for CYP2C9/VKORC1-guided coumarin anticoagulation was more heterogeneous with cost-effectiveness varying across contexts. Limited evidence suggested that SLCO1B1-guided statin therapy may be cost-effective, although data were sparse. No review reported pooled incremental cost-effectiveness ratios or net monetary benefit. Risk of bias was low in 7 reviews; AMSTAR 2 confidence was high in 4 and low in 5. Conclusion Cost-effectiveness of pharmacogenomics-guided cardiovascular treatment seems to vary by drug–gene pair, comparator, healthcare context, and modelling assumptions. Further real-world studies and standardized economic evaluations are needed to clarify broader clinical adoption.

ABSTRACT Indoor spaces contain diverse microbial communities that shape human health. These microorganisms are particularly relevant to respiratory diseases, including asthma and allergies. Despite growing recognition of the importance of indoor microbial exposures, research in this field is slowed by differences in methods. These inconsistencies make it difficult to compare results and draw conclusions. This systematic review analyses 106 studies published between 2000 and 2025 that investigated indoor microbiomes in dust, air, and other matrices across homes, schools, and other built environments. We assessed sampling strategies, DNA extraction protocols, sequencing technologies, and bioinformatic pipelines, identifying trends, inconsistencies, and areas requiring harmonisation. Passive sampling, particularly dust collection, was the most common approach, while Illumina‐based 16S rRNA and ITS amplicon sequencing dominated molecular analyses. However, variations in targeted gene regions, extraction kits, and analytical tools limited cross‐study comparability. Ecological findings revealed consistent detection of bacterial taxa such as Staphylococcus, Streptococcus, and Corynebacterium, and fungal taxa including Cladosporium, Aspergillus, and Penicillium, with diversity shaped by building characteristics, ventilation, humidity, occupancy, and presence of pets. This review highlights the need for standardised protocols in indoor microbiome research to facilitate reproducibility, enable meta‐analyses, and inform health‐related guidelines for indoor environments.

AimCOVID-19 pandemic, caused by SARS-CoV-2, has had a profound impact on global health, including in Bosnia and Herzegovina, which faced unique challenges due to limited testing and high mortality rates. This analysis aimed to identify mutations and detect different SARS-CoV-2 lineages across four pandemic waves.MethodologyA total of 127 SARS-CoV-2 samples were collected and sequenced from patients from the Federation of Bosnia and Herzegovina, providing a comprehensive overview of the viral genetic diversity in this region. Two sequencing platforms, Ion Torrent and Illumina, were used, whereby 37 samples were sequenced on the Ion Torrent platform, while others were sequenced on the Illumina platform.ResultsThis study presents a genomic analysis of SARS-CoV-2 variants circulating in the Federation of Bosnia and Herzegovina over four distinct pandemic waves, spanning from March 2020 to April 2023. Examination of genomic variations across these waves revealed key mutations associated with transmission and potential virulence.ConclusionThese genomic insights into SARS-CoV-2 evolution in Federation of Bosnia and Herzegovina emphasizes the importance of continuous surveillance to understand viral evolution and strengthen public health responses to future pandemics.