Should Antithrombotic Treatment Strategies in East Asians Differ from Caucasians? Focused on ACS or PCI-treated Patients.

Should Antithrombotic Treatment Strategies in East Asians Differ from Caucasians? Focused on ACS or PCI-treated Patients. Curr Vasc Pharmacol. 2018 Jan 16;: Authors: Bae JS, Ahn JH, Tantry U, Gurbel PA, Jeong YH Abstract With over 1.5 billion people, East Asians are the most populous race in the world. Health status in this population is an important global issue. In the contemporary trials of antithrombotic treatment, East Asian patients have a lower risk for atherothrombotic diseases (especially, coronary artery disease [CAD]) and a higher risk for bleeding (especially, gastrointestinal bleeding and hemorrhagic stroke). Despite these observations, antithrombotic treatment strategies in East Asian patients are mainly based on the American or European guidelines that are derived from randomized, controlled trials including mostly Caucasians. Despite a low response to clopidogrel, East Asian patients with CAD show a similar or even a lower rate of ischemic event occurrence and higher bleeding risk compared with Caucasian patients. The latter is referred to as the "East Asian Paradox", suggesting a dissimilar therapeutic window for antiplatelet therapy than Caucasians. In addition, different net clinical benefits have been observed between the races with potent P2Y12 inhibitors that may be related to racial differences in pharmacokinetic and pharmacodynamic profiles. Furthermore, there is emerging concern regarding differences between ...
Source: Current Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Vasc Pharmacol Source Type: research