Related Experiment Video

Updated: Aug 22, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.2K

Antithrombotic Therapy After Acute Coronary Syndromes or Percutaneous Coronary Interventions in East Asian

Osung Kwon1,2, Duk-Woo Park3

  • 1Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Eunpyeong St Mary's Hospital, Seoul, South Korea.

JACC. Asia
|November 7, 2022
PubMed

Insights

Antithrombotic therapy for acute coronary syndrome and percutaneous coronary intervention is complex. This review focuses on optimizing antithrombotic strategies for East Asian patients, considering their unique risk profiles.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Antithrombotic therapy guidelines evolve rapidly, increasing complexity in managing patients post-acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI).
  • Low enrollment of Asian populations in major randomized clinical trials (RCTs) restricts direct applicability of findings in Asian countries.
  • East Asian patients exhibit a distinct "East Asian paradox" with higher bleeding but lower thromboembolic event rates compared to Caucasians.

Purpose of the Study:

  • To summarize key randomized clinical trials (RCTs) on antithrombotic therapies conducted in East Asian cohorts.
  • To address the unique challenges and considerations for antithrombotic treatment in East Asian populations.
  • To propose future research directions for optimizing antithrombotic strategies in this demographic.

Main Methods:

  • Comprehensive review and summary of landmark randomized clinical trials (RCTs) focusing on antithrombotic therapies.
  • Analysis of East Asian cohort studies investigating antithrombotic treatment efficacy and safety.
  • Comparative assessment of treatment responses between East Asian and Caucasian patients.

Main Results:

  • Several RCTs have specifically investigated antithrombotic strategies in East Asian populations.
  • Evidence suggests differential responses to antithrombotic agents, highlighting the "East Asian paradox".
  • Findings from Western RCTs may require adaptation for effective use in East Asian clinical practice.

Conclusions:

  • Optimal antithrombotic therapy requires consideration of the unique epidemiological and physiological characteristics of East Asian patients.
  • Further research and tailored guidelines are necessary to refine antithrombotic strategies for ACS and PCI patients in East Asia.
  • Addressing the "East Asian paradox" is crucial for improving treatment outcomes and reducing adverse events.

Keywords:
ACS, acute coronary syndromeBARC, Bleeding Academic Research ConsortiumCAD, coronary artery diseaseCHIP, complex higher-risk and indicated procedure/patientsDAPT, dual antiplatelet therapyDES, drug-eluting stentDOAC, direct oral anticoagulantHBR, high bleeding riskMI, myocardial infarctionOAC, oral anticoagulationPCI, percutaneous coronary interventionPRU, P2Y12 reaction unitRCT, randomized controlled trialacute coronary syndromeantiplateletsantithrombotic therapypercutaneous coronary intervention

More Related Videos

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

3.6K
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

83.8K

Related Concept Videos

Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
22
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
22
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
18
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
15
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
602
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
19