Because guidelines and recommendations in response to multiple randomized clinical trials (RCTs) of new therapies undergo rapid changes, antithrombotic therapies for patients after acute coronary syndrome, or percutaneous coronary intervention, are becoming more complex in daily clinical practice. The proportion of Asian populations enrolled in landmark RCTs is substantially low, which limits the direct application of trial findings into clinical practice in Asian countries. Moreover, compared with Caucasian patients, East Asian patients are considered to have a different ischemia/bleeding propensity in response to antithrombotic therapy, known as the “East Asian paradox” (i.e. more bleeding events but fewer thromboembolic events). Coincident with consecutive RCTs in Western populations to optimize antithrombotic strategies, several such studies have now been conducted in East Asian cohorts. Herein, we provide a comprehensive summary of the key RCTs in this regard and propose future directions and perspectives for optimal antithrombotic therapies in East Asian patients.

JACC: Asia Editor-in-Chief 
Jian’an Wang, MD, PhD, FACC

CME Editor 
Kenneth A. Ellenbogen, MD

Authors
Osung Kwon, MD, PhD
Duk-woo Park, MD, PhD

Important Dates

Date of Release: February 15, 2022
Term of Approval/Date of CME/MOC/ECME Expiration: February 14, 2023