{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:23:52Z","timestamp":1792686232975,"version":"4.5.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate differences in clinical presentation and prognosis between East Asians and Europeans with atrial fibrillation (AF) who have experienced major bleeding (MB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We analysed two prospective registries enrolling AF patients from the Asian-Pacific Heart Rhythm Society (APHRS) and EURObservational Research Programme (EORP). Ethnicity was inferred by enrolment country. Major bleeding was defined as intracranial haemorrhages or significant extracranial bleeding. Primary outcomes included all-cause mortality and major adverse cardiovascular events (MACE). Logistic regression was utilized to explore clinical characteristics associated with prior MB. Cox models were constructed to assess the risk of primary outcomes in patients with and without a history of MB. Interaction analyses were performed to investigate the differences between the two cohorts. Out of the 597 patients with prior MB (3.8% of total cohort), 221 (37.0%) were East Asian. Patients with prior MB were older, more commonly East Asians, and had a higher cardiovascular burden than those without MB. A history of MB was associated with lower use of oral anticoagulants (OAC) [odds ratio (OR) 0.44, 95% confidence interval (CI) 0.35\u20130.54], particularly vitamin K antagonists (OR 0.73, 95% CI 0.59\u20130.90). Though associations for prior MB with MACE [hazard ratio (HR) 0.98, 95% CI 0.72\u20131.33] and thrombo-embolic events (HR 0.87, 95% CI 0.46\u20131.65) were not significant in entire population, they were more pronounced in East Asians compared to Europeans (P for interaction = 0.032 and 0.004, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following MB, East Asian patients with AF might be more susceptible to MACE and thromboembolism when compared to Europeans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf489","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T12:02:41Z","timestamp":1754049761000},"source":"Crossref","is-referenced-by-count":6,"title":["Ethnic differences in clinical outcomes following major bleeding in atrial fibrillation patients: a report from two prospective regional registries in Europe and Asia"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5073-1798","authenticated-orcid":false,"given":"Manlin","family":"Zhao","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , 6 West Derby Street, Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Cardiology, Capital Medical University affiliated Beijing Anzhen Hospital , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2895-6234","authenticated-orcid":false,"given":"Tommaso","family":"Bucci","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , 6 West Derby Street, Liverpool L7 8TX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven Ho Man","family":"Lam","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , 6 West Derby Street, Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Medicine and Therapeutics, The Chinese University of Hong Kong , New Territories ,","place":["Hong Kong"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , 6 West Derby Street, Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University , Jiangxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2808-6286","authenticated-orcid":false,"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , 6 West Derby Street, Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool , Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-7808","authenticated-orcid":false,"given":"Hung-Fat","family":"Tse","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, School of Clinical Medicine, Queen Mary Hospital, The University of Hong Kong , Hong Kong SAR ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Science, Italy University of Modena and Reggio Emilia, Policlinico di Modena , Modena ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7461-2793","authenticated-orcid":false,"given":"Tze-Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital , No. 201, Section 2, Shipai Road, Beitou District, Taipei 11217 ,","place":["Taiwan"]},{"name":"Institute of Clinical Medicine and Cardiovascular Research Centre, National Yang Ming Chiao Tung University , No. 155, Section 2, Linong Street, Beitou District, Taipei 112304 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , 6 West Derby Street, Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Clinical Medicine, Danish Centre for Health Services Research, Aalborg University , Selma Lagerl\u00f8fs Vej 2499260 Gistrup, Aalborg ,","place":["Denmark"]},{"name":"Department of Cardiology, Lipidology and Internal Medicine, Medical University of Bialystok , ul. \u017burawia 14, 15-540, Bialystok 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