Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Thromb Haemost. 2024 Sep;124(9):842-851. doi: 10.1055/a-2269-1123. Epub 2024 Feb 15.
This study aimed to evaluate racial differences in bleeding incidence by conducting an ecological epidemiological study using data from Korea and the United Kingdom.
We included healthy participants from the Korean National Health Insurance Service-Health Screening and the UK Biobank who underwent health examinations between 2006 and 2010 and had no comorbidities or history of medication use. Finally, 112,750 East Asians (50.7% men, mean age 52.6 years) and 210,995 Caucasians (44.7% men, mean age 55.0 years) were analyzed. The primary outcome was composed of intracranial hemorrhage (ICH) and bleeding from the gastrointestinal, respiratory, and genitourinary systems.
During the follow-up, primary outcome events occurred in 2,110 East Asians and in 6,515 Caucasians. East Asians had a 38% lower 5-year incidence rate compared with Caucasians (3.88 vs. 6.29 per 1,000 person-years; incidence rate ratio [IRR]: 0.62, 95% confidence interval [CI]: 0.59-0.65). East Asians showed a lower incidence of major bleeding (IRR: 0.86, 95% CI: 0.81-0.91), bleeding from the gastrointestinal (IRR: 0.53, 95% CI: 0.49-0.56), and genitourinary systems (IRR: 0.49, 95% CI: 0.44-0.53) compared with Caucasians. The incidence rates of ICH (IRR: 3.20, 95% CI: 2.67-3.84) and bleeding from the respiratory system (IRR: 1.28, 95% CI: 1.11-1.47) were higher in East Asians. Notably, East Asians consuming alcohol ≥3 times/week showed a higher incidence of the primary outcome than Caucasians (IRR: 1.12, 95% CI: 1.01-1.25).
This ecological study revealed significant racial differences in bleeding incidence, influenced by anatomical sites and lifestyle habits, underscoring the need for tailored approaches in bleeding management based on race.
本研究旨在通过对来自韩国和英国的数据进行生态流行病学研究，评估出血发生率的种族差异。
我们纳入了韩国国民健康保险服务-健康筛查和英国生物银行在 2006 年至 2010 年间接受健康检查且无合并症或用药史的健康参与者。最终，分析了 112750 名东亚人（50.7%为男性，平均年龄 52.6 岁）和 210995 名高加索人（44.7%为男性，平均年龄 55.0 岁）。主要结局由颅内出血（ICH）和胃肠道、呼吸道和泌尿生殖系统出血组成。
在随访期间，东亚人有 2110 人发生主要结局事件，高加索人有 6515 人发生主要结局事件。东亚人的 5 年发生率比高加索人低 38%（每 1000 人年 3.88 与 6.29；发生率比[IRR]：0.62，95%置信区间[CI]：0.59-0.65）。东亚人发生主要出血（IRR：0.86，95%CI：0.81-0.91）、胃肠道出血（IRR：0.53，95%CI：0.49-0.56）和泌尿生殖系统出血（IRR：0.49，95%CI：0.44-0.53）的发生率均低于高加索人。ICH（IRR：3.20，95%CI：2.67-3.84）和呼吸道出血（IRR：1.28，95%CI：1.11-1.47）的发生率在东亚人更高。值得注意的是，每周饮酒≥3 次的东亚人主要结局的发生率高于高加索人（IRR：1.12，95%CI：1.01-1.25）。
本生态研究揭示了出血发生率的显著种族差异，受解剖部位和生活方式习惯的影响，这凸显了基于种族制定出血管理个体化方法的必要性。
