Purpose: East Asian individuals have a lower risk of thromboembolic events while potentially carrying a higher risk of bleeding events compared with non-Asian individuals. The aim of the present analysis was to investigate the effectiveness and safety of the de-escalation of antiplatelet therapy compared with standard dual antiplatelet therapy (DAPT) in East Asian patients undergoing percutaneous coronary intervention (PCI).
Methods: Randomized controlled trials comparing de-escalation with DAPT in patients with acute coronary syndrome (ACS) were retrieved from electronic databases from their inception until March 2022. Outcomes included major adverse cardiovascular events (MACE), ischemic events, major bleeding, minor bleeding, and any bleeding. Subgroup analyses based on treatment strategy were conducted. Statistical analysis was performed by using Review Manager version 5.4.
Findings: Eight randomized controlled trials from 539 potentially relevant publications with a total of 15,744 East Asian patients were included. Pooled data from these studies found a significantly lower MACE (0.82; 95% CI, 0.69-0.98) and major bleeding event (0.62; 95% CI, 0.46-0.82) in de-escalation than standard-DAPT without heterogeneity. Subgroup analysis was divided into DAPT followed by P2Y inhibitor monotherapy and a reducing dose of P2Y inhibitors. DAPT followed by P2Y inhibitor monotherapy had a 48% lower incidence of major bleeding events than standard DAPT (0.52; 95% CI, 0.27-1.00); there was no significant difference in major bleeding (0.99; 95% CI, 0.55-1.76) between the reducing dose of P2Y inhibitors and standard DAPT.
Implications: De-escalation is a promising and potentially optimal antiplatelet therapy for patients from East Asia with PCI. DAPT followed by P2Y inhibitor monotherapy might be a safer and equally effective approach compared with standard DAPT in East Asian patients with PCI. PROSPERO identifier: CRD42022319983.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.clinthera.2023.08.004 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
DNA methylation at birth and IgE trajectories from birth to adolescence, different patterns between White and Asian.
Epigenomics
January 2025
NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Aim: We aim to assess association of DNA methylation (DNAm) at birth with total immunoglobulin E (IgE) trajectories from birth to late adolescence and whether such association is ethnicity-specific.
Methods: We examined the association of total IgE trajectories from birth to late adolescence with DNAm at birth in two independent birth cohorts, the Isle of wight birth cohort (IOWBC) in UK ( = 796; White) and the maternal and infant cohort study (MICS) in Taiwan ( = 60; Asian). Biological pathways and methylation quantitative trait loci (methQTL) for associated Cytosine-phosphate-Guanine sites were studied.
Chinese Registry of Rheumatoid Arthritis (CREDIT) VI: Temporal Trends in Patients With Early Rheumatoid Arthritis and Moderate-To-Severe Disease Activity - A Multicenter Cohort Study of Treatment Strategies and Outcomes.
Int J Rheum Dis
January 2025
Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences and Peking Union Medical College; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology; State Key Laboratory of Complex Severe and Rare Diseases; Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
Aim: The continuous update of international guidelines and enhanced availability of biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) have made a significant impact on the diagnosis and treatment of early rheumatoid arthritis (ERA). This study aims to systematically evaluate the current treatment strategies and outcomes within a large-scale cohort of patients with ERA.
Methods: Data from the Chinese Registry of Rheumatoid Arthritis (CREDIT), a large multicenter Chinese registry of RA, were collected to analyze temporal trends in clinical profiles, therapeutic strategies, and treatment outcomes among patients with ERA.
Substitution and Complementarity in the Consumption of Alcohol, Cannabis, and Opium.
Health Econ
January 2025
School of Economics, Georgia Institute of Technology, Atlanta, Georgia, USA.
Understanding the behavior of populations of drug consumers has been and remains a topic of keen interest. Using a unique dataset on 25 districts from Bengal, India, from 1911 to 1925, we analyze whether populations of consumers treat alcohol, cannabis, and opium as economic substitutes or complements in a legal regime. Additionally, we examine responsiveness to prices and income.
View Article and Find Full Text PDFCardiovascular risk profiling among South Asian adults in Hong Kong: a latent class analysis.
Int J Equity Health
January 2025
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Background: South Asians living in urbanized settings are facing disproportionate cardiovascular burden largely attributable to modifiable risk factors. Given the rapid surge in South Asian population in Hong Kong, this study aims to identify and distinguish clusters of cardiovascular risk profiles among community-dwelling South Asian adults.
Methods: Between June 2022 and December 2023, 1181 South Asian adults were recruited through territory-wide outreach health assessments on lifestyle, psychological distress, obesity, clinical cardiovascular conditions, and sociodemographic factors.
Atypical pulmonary manifestations suggestive of lung cancer in behçet's disease with spontaneously regressing lymphadenopathy and a lung mass: a case report.
BMC Pulm Med
January 2025
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, 301-721, Republic of Korea.
Background: Behçet's disease (BD) is a multisystem inflammatory disorder that can affect various organs, including the lungs. Pulmonary manifestations are rare and typically present as pulmonary artery aneurysms.
Case Presentation: We report the case of a 56-year-old East Asian male with a 27-year history of BD, who had no respiratory symptoms, such as hemoptysis, cough, or fever.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!