Ethnic Difference of Thrombogenicity in Patients with Cardiovascular Disease: A Pandora Box to Explain Prognostic Differences

Hyun Kuk Kim, Udaya S. Tantry, Hyun-Woong Park, Tobias Geisler, Diana Gorog, Paul A Gurbel, Young-Hoon Jeong

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Abstract

Arterial and venous atherothrombotic events are finely regulated processes involving a complex interplay between vulnerable blood, vulnerable vessel, and blood stasis. Vulnerable blood ('thrombogenicity') comprises complex interactions between cellular components and plasma factors (inflammatory, procoagulant, anticoagulant, and fibrinolytic factors). The extent of thrombogenicity may determine the progression of atheroma and the clinical manifestation of atherothrombotic events, with the highest thrombogenicity in African Americans and lowest in East Asians. Inherent thrombogenicity may influence clinical efficacy and safety of specific antithrombotic treatments in high-risk patients, which may in part explain the observation that East Asian patients have reduced anti-ischemic benefits and elevated bleeding risk with antithrombotic therapy compared to Caucasian patients. In this review, we discuss available evidence regarding the racial differences in thrombogenicity and its impact on clinical outcomes among patients with atherosclerotic cardiovascular disease.

Original languageEnglish
Pages (from-to)202-221
Number of pages20
JournalKorean Circulation Journal (KCJ)
Volume51
Issue number3
Early online date9 Feb 2021
DOIs
Publication statusPublished - 1 Mar 2021

Keywords

  • Antithrombotic treatment
  • Coagulation
  • Inflammation
  • Race
  • Thrombogenicity

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