Kim Hyun Kuk, Tantry Udaya S, Park Hyun Woong, Shin Eun Seok, Geisler Tobias, Gorog Diana A, Gurbel Paul A, Jeong Young Hoon
Department of Cardiology, Chosun University Hospital, Gwangju, Korea.
Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Korean Circ J. 2021 Mar;51(3):202-221. doi: 10.4070/kcj.2020.0537.
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.
动脉和静脉粥样血栓形成事件是精细调节的过程，涉及易损血液、易损血管和血流淤滞之间复杂的相互作用。易损血液（“血栓形成倾向”）包括细胞成分与血浆因子（炎症、促凝血、抗凝和纤溶因子）之间的复杂相互作用。血栓形成倾向的程度可能决定动脉粥样硬化的进展以及动脉粥样血栓形成事件的临床表现，其中非洲裔美国人的血栓形成倾向最高，东亚人最低。内在的血栓形成倾向可能影响高危患者特定抗栓治疗的临床疗效和安全性，这可能部分解释了以下观察结果：与白种人患者相比，东亚患者接受抗栓治疗时抗缺血获益减少且出血风险升高。在本综述中，我们讨论了关于血栓形成倾向的种族差异及其对动脉粥样硬化性心血管疾病患者临床结局影响的现有证据。
