The East Asian Paradox: An Updated Position Statement on the Challenges to the Current Antithrombotic Strategy in Patients with Cardiovascular Disease
Journal
Thrombosis and Haemostasis
Date Issued
2020
Author(s)
Kim H.K.
Tantry U.S.
Smith S.C.
Jeong M.H.
Park S.-J.
Kim M.H.
Lim D.-S.
Shin E.-S.
Park D.-W.
Huo Y.
Chen S.-L.
Bo Z.
Goto S.
Kimura T.
Yasuda S.
Chan M.
Aradi D.
Geisler T.
Gorog D.A.
Sibbing D.
Lip G.Y.H.
Angiolillo D.J.
Gurbel P.A.
Jeong Y.-H.
Abstract
East Asian patients have reduced anti-ischemic benefits and increased bleeding risk during antithrombotic therapies compared with Caucasian patients. As potent P2Y 12 receptor inhibitors (e.g., ticagrelor and prasugrel) and direct oral anticoagulants are commonly used in current daily practice, the unique risk-benefit trade-off in East Asians has been a topic of emerging interest. In this article, we propose updated evidence and future directions of antithrombotic treatment in East Asian patients. ? 2020. Thieme. All rights reserved.
Subjects
antiplatelet therapy; bleeding risk; direct oral anticoagulants; ischemic risk; race
SDGs
Other Subjects
acetylsalicylic acid; anticoagulant agent; antithrombin; apixaban; blood clotting factor 5; blood clotting factor 7; blood clotting factor 8; C reactive protein; clopidogrel; D dimer; dabigatran; edoxaban; endothelial leukocyte adhesion molecule 1; fibrinogen; prasugrel; prothrombin; rivaroxaban; ticagrelor; von Willebrand factor; warfarin; acute coronary syndrome; atrial fibrillation; bleeding risk score; blood clotting; brain hemorrhage; cardiovascular disease; carotid artery disease; Caucasian; clinical outcome; clinical study; comorbidity; deep vein thrombosis; drug dose reduction; drug withdrawal; dual antiplatelet therapy; East Asian; endothelial dysfunction; ethical dilemma; ethnicity; gene mutation; Helicobacter pylori; human; ischemia; meta analysis (topic); monotherapy; mortality; randomized controlled trial (topic); Review; thrombophilia
Type
review