The East Asian Paradox: An Updated Position Statement on the Challenges to the Current Antithrombotic Strategy in Patients with Cardiovascular Disease

Hyun Kuk Kim; Udaya S. Tantry; Sidney C. Smith Jr.; Myung Ho Jeong; Seung-Jung Park; Moo Hyun Kim; Do-Sun Lim; Eun-Seok Shin; Duk-Woo Park; Yong Huo; Shao-Liang Chen; Zheng Bo; Shinya Goto; Takeshi Kimura; Satoshi Yasuda; Wen-Jone Chen; Mark Chan; Daniel Aradi; Tobias Geisler; Diana A. Gorog; Dirk Sibbing; Gregory Y. H. Lip; Dominick J. Angiolillo; Paul A. Gurbel; Young-Hoon Jeong

doi:10.1055/s-0040-1718729

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2021; 121(04): 422-432
DOI: 10.1055/s-0040-1718729

Review Article

The East Asian Paradox: An Updated Position Statement on the Challenges to the Current Antithrombotic Strategy in Patients with Cardiovascular Disease

Authors

Hyun Kuk Kim

¹Department of Cardiology, Chosun University Hospital, Gwangju, South Korea
Udaya S. Tantry

²Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
Sidney C. Smith Jr.

³Division of Cardiology, University of North Carolina, Chapel Hill, North Carolina, United States
Myung Ho Jeong

⁴Department of Cardiology, Chonnam National University Hospital, Gwangju, South Korea
Seung-Jung Park

⁵The Heart Institute, Asan Medical Center, University of Ulsan, Seoul, South Korea
Moo Hyun Kim

⁶Department of Cardiology, Dong-A University Hospital, Busan, South Korea
Do-Sun Lim

⁷Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, South Korea
Eun-Seok Shin

⁸Division of Cardiology, Ulsan Hospital, Ulsan, South Korea
Duk-Woo Park

⁵The Heart Institute, Asan Medical Center, University of Ulsan, Seoul, South Korea
Yong Huo

⁹Department of Cardiology, Peking University First Hospital, Beijing, China
Shao-Liang Chen

¹⁰Cardiovascular Department, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
Zheng Bo

⁹Department of Cardiology, Peking University First Hospital, Beijing, China
Shinya Goto

¹¹Department of Medicine (Cardiology), Tokai University School of Medicine, Kanagawa, Japan
Takeshi Kimura

¹²Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
Satoshi Yasuda

¹³National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
Wen-Jone Chen

¹⁴Department of Internal Medicine, Cardiology Division, National Taiwan University Hospital, Taipei, Taiwan
Mark Chan

¹⁵Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
Daniel Aradi

¹⁶Heart Centre Balatonfüred and Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
Tobias Geisler

¹⁷Department of Cardiology and Cardiovascular Medicine, University Hospital of Tübingen, Tübingen, Germany
Diana A. Gorog

¹⁸National Heart and Lung Institute, Imperial College, London, United Kingdom

¹⁹Postgraduate Medical School, University of Hertfordshire, Hertfordshire, United Kingdom
Dirk Sibbing

²⁰Department of Cardiology, LMU München, Munich, Germany

²¹DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
Gregory Y. H. Lip

²²Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
Dominick J. Angiolillo

²³Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States
Paul A. Gurbel

²Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
Young-Hoon Jeong

²⁴Department of Internal Medicine, Gyeongsang National University School of Medicine and Cardiovascular Center, Gyeongsang National University Changwon Hospital, Changwon, South Korea

²⁵Institute of the Health Sciences, Gyeongsang National University, Jinju, South Korea

Abstract

East Asian patients have reduced anti-ischemic benefits and increased bleeding risk during antithrombotic therapies compared with Caucasian patients. As potent P2Y₁₂ 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.

Keywords

race - antiplatelet therapy - direct oral anticoagulants - ischemic risk - bleeding risk

Volltext

Referenzen

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