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Comparative Study
. 2024 Sep;124(9):842-851.
doi: 10.1055/a-2269-1123. Epub 2024 Feb 15.

Racial Differences in Bleeding Risk: An Ecological Epidemiological Study Comparing Korea and United Kingdom Subjects

Dong-Seon Kang  1 , Pil-Sung Yang  2 , Daehoon Kim  1 , Eunsun Jang  1 , Hee Tae Yu  1 , Tae-Hoon Kim  1 , Jung Hoon Sung  2 , Hui-Nam Pak  1 , Moon-Hyoung Lee  1 , Gregory Y H Lip  3   4 , Boyoung Joung  1
Affiliations
Comparative Study

Racial Differences in Bleeding Risk: An Ecological Epidemiological Study Comparing Korea and United Kingdom Subjects

Dong-Seon Kang et al. Thromb Haemost. 2024 Sep.

Abstract

Background: This study aimed to evaluate racial differences in bleeding incidence by conducting an ecological epidemiological study using data from Korea and the United Kingdom.

Methods: We included healthy participants from the Korean National Health Insurance Service-Health Screening and the UK Biobank who underwent health examinations between 2006 and 2010 and had no comorbidities or history of medication use. Finally, 112,750 East Asians (50.7% men, mean age 52.6 years) and 210,995 Caucasians (44.7% men, mean age 55.0 years) were analyzed. The primary outcome was composed of intracranial hemorrhage (ICH) and bleeding from the gastrointestinal, respiratory, and genitourinary systems.

Results: During the follow-up, primary outcome events occurred in 2,110 East Asians and in 6,515 Caucasians. East Asians had a 38% lower 5-year incidence rate compared with Caucasians (3.88 vs. 6.29 per 1,000 person-years; incidence rate ratio [IRR]: 0.62, 95% confidence interval [CI]: 0.59-0.65). East Asians showed a lower incidence of major bleeding (IRR: 0.86, 95% CI: 0.81-0.91), bleeding from the gastrointestinal (IRR: 0.53, 95% CI: 0.49-0.56), and genitourinary systems (IRR: 0.49, 95% CI: 0.44-0.53) compared with Caucasians. The incidence rates of ICH (IRR: 3.20, 95% CI: 2.67-3.84) and bleeding from the respiratory system (IRR: 1.28, 95% CI: 1.11-1.47) were higher in East Asians. Notably, East Asians consuming alcohol ≥3 times/week showed a higher incidence of the primary outcome than Caucasians (IRR: 1.12, 95% CI: 1.01-1.25).

Conclusion: This ecological study revealed significant racial differences in bleeding incidence, influenced by anatomical sites and lifestyle habits, underscoring the need for tailored approaches in bleeding management based on race.

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Conflict of interest statement

B.J. has served as a speaker for Bayer, BMS/Pfizer, Medtronic, and Daiichi-Sankyo and received research funds from Medtronic and Abbott. No fees have been received directly or personally. G.Y.H.L. has been a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, Daiichi-Sankyo, and Anthos. No fees are received personally. He is co-principal investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union's Horizon 2020 Research and Innovation Program under grant agreement number 899871. The remaining authors have nothing to declare.

Figures

Fig. 1
Fig. 1
Flow chart of enrollment and analysis of the participants. a Medications include oral anticoagulants, aspirin, P 2 Y 12 inhibitors, statins, β blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, loop diuretics, and potassium-sparing diuretics. AF, atrial fibrillation; COPD, chronic obstructive pulmonary disease; K-NHIS-HealS, Korean National Health Insurance Service-Health Screening.
Fig. 2
Fig. 2
Bar graph of 5-year incidence rates according to race. The incidence rates of the primary outcome are presented in panel ( A ), and the incidence rates of each component of the secondary outcome are presented in panel ( B ). Error bars indicate 95% confidence intervals for the incidence rates.
Fig. 3
Fig. 3
Proportional distribution of components within the primary outcome. This figure illustrates the proportion, in No. (%), of each anatomical site of bleeding origin within the total bleeding events.
See this image and copyright information in PMC

References

    1. Roberts S E, Button L A, Williams J G. Prognosis following upper gastrointestinal bleeding. PLoS One. 2012;7(12):e49507. - PMC - PubMed
    1. Poon M T, Fonville A F, Al-Shahi Salman R. Long-term prognosis after intracerebral haemorrhage: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2014;85(06):660–667. - PubMed
    1. Kim H K, Tantry U S, Smith S C, Jr et al.The East Asian Paradox: an updated position statement on the challenges to the current antithrombotic strategy in patients with cardiovascular disease. Thromb Haemost. 2021;121(04):422–432. - PubMed
    1. Japanese Circulation Society and Japanese Heart Rhythm Society Joint Working Group . Ono K, Iwasaki Y K, Akao M et al.JCS/JHRS 2020 guideline on pharmacotherapy of cardiac arrhythmias. Circ J. 2022;86(11):1790–1924. - PubMed
    1. Wang F W, Chuang H Y, Tu M S et al.Prevalence and risk factors of asymptomatic colorectal diverticulosis in Taiwan. BMC Gastroenterol. 2015;15:40. - PMC - PubMed

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