Key result
East Asians exhibit lower atherothrombotic risk but higher bleeding tendency versus Caucasians and Blacks.
Why the study?
Despite guideline-directed medical therapy, post-PCI patients face recurrent atherothrombotic events due to residual cardiovascular risks, with racial differences altering the balance between antithrombotic efficacy and safety.
This review highlights racial differences in atherothrombotic cardiovascular risks, particularly the lower risk in East Asians, advocating for personalized antithrombotic strategies post-PCI.
Suggests ethnicity-informed antithrombotic choices post-PCI; hypothesis-generating and requires prospective validation.
Following percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD), patients may face a prolonged elevated risk of atherothrombotic events.This enduring vulnerability underscores the need for refined secondary prevention strategies, grounded in a deepening understanding of the pathobiology involved.The shift in CAD pathophysiology research from focusing on 'vulnerable plaques' to embracing the concept of the 'vulnerable patient', emphasizing the essential role of medical therapy in secondary prevention.Despite the current guideline-directed medical therapy, a consistent proportion of post-PCI patients experience recurrent atherothrombotic events due to unaddressed 'residual atherothrombotic cardiovascular (CV) risks'.Contemporary clinical research highlights the pivotal role of lipid phenotype, systemic inflammation, glycemia, platelets, coagulation, and fibrinolytic activity, advocating for a more personalized, targeted therapeutic approach.Balance between clinical efficacy and safety during antithrombotic agents may be different according to 'residual atherothrombotic CV risks'.Blacks generally exhibits the highest level of atherothrombotic CV risks, followed by Hispanics and Caucasians with comparable levels, and finally the lowest level is observed in East Asians, which will be a major factor supporting the 'East Asian Paradox'.In this review, we discuss available evidence regarding the racial differences in atherothrombotic CV risks and its impact on clinical post-PCI outcomes to determine precision medicine for antithrombotic strategies.
No takes yet. Share an insight, caveat, or question.
Jeong et al. (2024) conducted a review in Atherothrombotic Cardiovascular Risks. Tailored antithrombotic strategies was evaluated. East Asians exhibit the lowest atherothrombotic cardiovascular risks and a higher tendency for bleeding compared to Caucasians and Blacks, supporting the need for tailored antithrombotic strategies.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: