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Ethnic variation in adverse cardiovascular outcomes and bleeding complications in the Clopidogrel for High

Koon-Hou Mak1, Deepak L Bhatt, Mingyuan Shao

  • 1Gleneagles Medical Centre, Singapore, Singapore. makheart@gmail.com

American Heart Journal
|April 1, 2009
PubMed

Insights

Ethnicity did not predict major cardiovascular events in antiplatelet therapy trials. However, Black and Hispanic patients had higher mortality, while Black and Asian patients faced increased moderate bleeding risks.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Trials
  • Health Disparities

Background:

  • Atherothrombosis affects global populations, but its impact across diverse ethnic groups on evidence-based therapies remains unclear.
  • Understanding ethnic variations in cardiovascular event risk and bleeding complications is crucial for personalized medicine.

Purpose of the Study:

  • To investigate if ethnicity independently predicts cardiovascular events and bleeding complications in patients receiving antiplatelet therapy.
  • To analyze ethnic differences in outcomes within a large contemporary clinical trial.

Main Methods:

  • Prospective observational study of 15,603 patients from the CHARISMA trial.
  • Median follow-up of 28 months, with primary endpoints for efficacy (cardiovascular death, myocardial infarction, stroke) and safety (bleeding).

Main Results:

  • No significant difference in the primary composite cardiovascular endpoint across White, Black, Asian, and Hispanic groups.
  • Black and Hispanic patients showed higher rates of cardiovascular and all-cause mortality compared to Asians.
  • Asian and Black patients had a higher likelihood of moderate bleeding complications than Hispanic patients.

Conclusions:

  • Ethnicity was not an independent predictor of the primary composite cardiovascular event in this antiplatelet therapy trial.
  • Ethnicity significantly predicted secondary outcomes, including cardiovascular/all-cause mortality (Black and Hispanic groups) and moderate bleeding (Black and Asian groups).
Abstract

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