关于东亚人冠状动脉疾病抗血小板治疗的立场声明:2025年更新
Yanjun Gong1, Young-Hoon Jeong2, Tzung-Dau Wang3
1Department of Cardiology, Peking University First Hospital, Beijing, China.
JACC. Asia
|July 3, 2025
概括
接受抗血小板治疗的东亚患者面临着独特的心血管风险效益平衡. 这份共识审查了对东亚冠状动脉病患者群体抗血小板策略的当前证据和建议.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 遗传学 是一个遗传学.
背景情况:
- 东亚人群在抗血小板治疗中表现出明显的"东亚悖论",与西方人群相比,心血管事件风险较低,但出血风险更高.
- 影响这种悖论的因素包括遗传倾向,环境影响,如Helicobacter pylori感染,以及特定的心血管风险概况.
- 关于个性化风险评估,降低双重抗血小板治疗的升级,以及东亚冠状动脉疾病患者长期坚持治疗的知识差距仍然存在.
研究的目的:
- 综合关于东亚冠状动脉疾病患者抗血小板治疗的最新研究.
- 解决关键问题,如个性化风险效益评估和降级战略.
- 为这个特定的人群提供基于证据的治疗建议.
主要方法:
- 这一共识更新是基于对现有临床证据和最近研究的全面审查.
- 它综合了数据,重点关注东亚个体独特的药理动力学反应和治疗范围.
- 更新强调了来自东亚的研究结果,特别是那些支持降级战略的研究结果.
主要成果:
- 证据表明,在东亚人群中,对P2Y12抑制剂的药理动力学反应加剧,影响治疗结果.
- 双重抗血小板治疗的降级策略在东亚队列中显示出积极的结果.
- 显著的风险益处概况需要在这个人口群体中量身定制的抗血小板治疗方法.
结论:
- 抗血小板治疗需要对东亚冠状动脉疾病患者进行个性化治疗,考虑到他们独特的风险概况.
- 为双重抗血小板治疗优化降级策略对于管理东亚悖论至关重要.
- 需要进一步的研究和共识,以完善长期的二次预防策略在这个人群中.
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