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

Korean Circulation Journal 2021년 51권 3호 p.202 ~ 221
김현국, Tantry Udaya S., 박현웅, 신은석, Geisler Tobias, Gorog Diana A., Gurbel Paul A., 정영훈,
소속 상세정보
김현국 ( Kim Hyun-Kuk ) - Chosun University Hospital Department of Internal Medicine
 ( Tantry Udaya S. ) - Sinai Hospital of Baltimore Sinai Center for Thrombosis Research
박현웅 ( Park Hyun-Woong ) - Gyeongsang National University School of Medicine Department of Internal Medicine
신은석 ( Shin Eun-Seok ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Cardiology
 ( Geisler Tobias ) - University Hospital of Tubingen Department of Cardiology and Angiology
 ( Gorog Diana A. ) - Imperial College London National Heart and Lung Institute
 ( Gurbel Paul A. ) - Sinai Hospital of Baltimore Sinai Center for Thrombosis Research
정영훈 ( Jeong Young-Hoon ) - Gyeongsang National University School of Medicine Department of Internal Medicine

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.

키워드

Thrombogenicity; Coagulation; Inflammation; Race; Antithrombotic treatment

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