Summary
Currently available clinical database was mostly developed in North America and Europe
(Western Countries). Clinical database of Asian patients are still not large enough
to develop Asian region specific clinical guidelines, although the population of patients
in the majority of Asia countries are increasing rapidly. Marked ethnic and life-style
heterogeneity within Asian region also makes it difficult to develop Asian region
specific Evidence-based clinical practice guidelines. In general, there are certain
differences in the background epidemiology of the athero-sclerotic and thrombotic
diseases in Asia countries and Western ones such as Asian patients are more prone
to cerebrovascular disease (CVD) than coronary artery disease (CAD). Accordingly,
there also are marked differences in the use of antiplatelet agents in Asian patients
underwent coronary intervention (such as frequent use of cilostazol) as compared to
those living in the Western countries. Currently available database also suggests
the difference in side effects of anti -platelet agents in Asian patients as compared
to Western ones such as relatively high incidence of hepatic dysfunction with the
use of thienopiridine. In the future, it would be important to clarify the detailed
difference of Asian patients and Western ones in regards to the effects and side effects
of antiplatelet therapy by the multi-national prospective observation registry and
clinical trials including equal number of Asian and Western patients. It would also
be important for Asian physician to develop scientifically valid methods to import
the results of “Global Evidence” with appropriate modification for the clinical practice
in patients living in the specific region of Asia.
Keywords
Antiplatelet agents - Asia - Japan - aspirin - ticlopidine - clopidogrel - atrial
fibrillation - intracranial bleeding
