JACC Asia

Position statement: East Asian patients with coronary artery disease benefit from tailored anti-platelet therapy

July 24, 2025

A complex array of genetic, physical, and other factors affects the risk-benefit ratio of anti-platelet therapy for East Asian patients with coronary artery disease (CAD), including lower body weight, higher bleeding risks with antiplatelet therapy, lower cardiovascular event risks, increased pharmacodynamic responses to P2Y12 inhibitor drugs, etc. In this position statement, authors advocate for assessment of each individual’s ischemic and bleeding risks in tailoring anti-platelet therapy decisions.

Substantial evidence supports de-escalating dual anti-platelet therapy in East Asians. The consensus group authoring this position statement doesn’t support long-term (more than 12 months) maintenance of dual anti-platelet therapy for East Asian patients—even in acute coronary syndrome patients at high ischemic risk, and they support active de-escalation of dual anti-platelet therapy. Specific recommendations are offered for various clinical scenarios.

Source:

Gong Y, et al. (2025, July 1). JACC Asia. Position Statement on Antiplatelet Therapy for East Asians With Coronary Artery Disease: 2025 Update. https://www.jacc.org/doi/10.1016/j.jacasi.2025.04.010