What question did this study set out to answer?

To review experimental and clinical evidence comparing the efficacy, safety, and pharmacodynamics of antithrombotic regimens between East Asian and Caucasian patients.

January 18, 2018Current Vascular Pharmacology

Should Antithrombotic Treatment Strategies in East Asians Differ from Caucasians?

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Why the study?

Does the efficacy and safety of antithrombotic agents differ between East Asian and Caucasian patients with CAD?

Key Points

To review experimental and clinical evidence comparing the efficacy, safety, and pharmacodynamics of antithrombotic regimens between East Asian and Caucasian patients.
Synthesized experimental, pharmacokinetic, and pharmacodynamic evidence evaluating antiplatelet agents and anticoagulants across racial groups.
Analyzed clinical trial outcomes focusing on patients with coronary artery disease and those undergoing percutaneous coronary intervention.
East Asian patients exhibit lower baseline risk for atherothrombotic diseases but higher vulnerability to gastrointestinal bleeding and hemorrhagic stroke compared to Caucasian patients.
Despite displaying a reduced laboratory response to clopidogrel, East Asian patients maintain similar or lower ischemic event rates alongside higher bleeding risk, establishing the East Asian Paradox.
Variations in pharmacokinetic and pharmacodynamic responses to potent P2Y12 inhibitors and anticoagulants result in disparate net clinical benefit profiles between East Asian and Western populations.

Structured PICO

Does the efficacy and safety of antithrombotic agents differ between East Asian and Caucasian patients with CAD?

Population

East Asian patients with coronary artery disease (CAD) and/or undergoing percutaneous coronary intervention (PCI)

Intervention

Antithrombotic treatment (antiplatelet therapy, P2Y12 inhibitors, anticoagulant agents)

Comparator

Caucasian/Western patients and standard American/European guidelines

Outcome

Efficacy (ischemic event occurrence) and safety (bleeding risk)

Highlights the 'East Asian Paradox' and advocates for race-tailored antithrombotic treatment strategies in East Asian patients with CAD or undergoing PCI.

Discussion

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Implication

The East Asian Paradox supports ethnicity-informed bleeding risk assessment in CAD antithrombotic therapy; leaves open optimal strategies pending dedicated RCTs.

Cite This Study

Bae et al. (2018) studied this question.

synapsesocial.com/papers/69a30061efb2b0e59c0a3e65 https://doi.org/10.2174/1570161116666180117103238

Topics

Dual antiplatelet therapy Coronary artery disease Percutaneous coronary intervention Anticoagulation in AF

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Implication

The East Asian Paradox supports ethnicity-informed bleeding risk assessment in CAD antithrombotic therapy; leaves open optimal strategies pending dedicated RCTs.

Should Antithrombotic Treatment Strategies in East Asians Differ from Caucasians?

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Should Antithrombotic Treatment Strategies in East Asians Differ from Caucasians?

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider