{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:12:31Z","timestamp":1793196751663,"version":"4.5.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2019,1]]},"abstract":"\n Background\u2003Prolonged dual anti-platelet therapy (DAPT) is intended to reduce ischaemic events, at the cost of an increased bleeding risk in patients undergoing percutaneous coronary intervention (PCI). In this study, we evaluated whether race influences the ischaemia\/bleeding risk trade-off.<\/jats:p>\n Methods\u2003We searched for randomized clinical trials (RCTs) comparing DAPT duration after PCI. To compare the benefit or harm between DAPT duration by race, individual patient-level landmark meta-analysis was performed after discontinuation of the shorter duration DAPT group in each RCT. The primary ischaemic endpoint was major adverse cardiac events (MACEs), and the primary bleeding endpoint was major bleeding events (clinicaltrials.gov NCT03338335).<\/jats:p>\n Results\u2003Seven RCTs including 16,518 patients (8,605 East Asians, 7,913 non-East Asians) were pooled. MACE occurred more frequently in non-East Asians (0.8% vs. 1.8%, p\u2009<\u20090.001), while major bleeding events occurred more frequently in East Asians (0.6% vs. 0.3%, p\u2009=\u20090.001). In Cox proportional hazards model, prolonged DAPT significantly increased the risk of major bleeding in East Asians (hazard ratio [HR], 2.843, 95% confidence interval [CI], 1.474\u20135.152, p\u2009=\u20090.002), but not in non-East Asians (HR, 1.375, 95% CI, 0.523\u20133.616, p\u2009=\u20090.523). East Asians had a higher median probability risk ratio of bleeding to ischaemia (0.66 vs. 0.15), and the proportion of patients with higher probability of bleeding than ischaemia was significantly higher in East Asians (32.3% vs. 0.4%, p\u2009<\u20090.001).<\/jats:p>\n Conclusion\u2003We suggest that the ischaemia\/bleeding trade-off may be different between East Asians and non-East Asians. In East Asians, prolonged DAPT may have no effect in reducing the ischaemic risk, while significantly increases the bleeding risk.<\/jats:p>","DOI":"10.1055\/s-0038-1676545","type":"journal-article","created":{"date-parts":[[2018,12,31]],"date-time":"2018-12-31T18:31:15Z","timestamp":1546281075000},"page":"149-162","source":"Crossref","is-referenced-by-count":142,"title":["Racial Differences in Ischaemia\/Bleeding Risk Trade-Off during Anti-Platelet Therapy: Individual Patient Level Landmark Meta-Analysis from Seven RCTs"],"prefix":"10.1055","volume":"119","author":[{"given":"Jeehoon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tullio","family":"Palmerini","sequence":"additional","affiliation":[{"name":"Dipartimento Cardio-Toraco-Vascolare, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg","family":"Stone","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center\/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Colombo","sequence":"additional","affiliation":[{"name":"San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaide","family":"Chieffo","sequence":"additional","affiliation":[{"name":"San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Feres","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Abizaid","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, Massachusetts, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Valgimigli","sequence":"additional","affiliation":[{"name":"Swiss Cardiovascular Center, Bern University Hospital, Bern University, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myeong-Ki","family":"Hong","sequence":"additional","affiliation":[{"name":"Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangsoo","family":"Jang","sequence":"additional","affiliation":[{"name":"Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Gilard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Brest University, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Claude","family":"Morice","sequence":"additional","affiliation":[{"name":"G\u00e9n\u00e9rale de Sant\u00e9, Institut Cardiovasculaire Paris Sud, Massy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duk-Woo","family":"Park","sequence":"additional","affiliation":[{"name":"The Heart Institute, University of Ulsan College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Jung","family":"Park","sequence":"additional","affiliation":[{"name":"The Heart Institute, University of Ulsan College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Hoon","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiesuck","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bon-Kwon","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo-Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,12,31]]},"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0038-1676545.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T17:13:32Z","timestamp":1557162812000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0038-1676545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,31]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2018,12,31]]},"published-print":{"date-parts":[[2019,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0038-1676545","relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,31]]}}}