Racial Difference in Blood Clotting Warrants a Closer Look at Heart Attack Medications

Thomas Jefferson University researchers have discovered that the formation of blood clots follows a different molecular route in African Americans versus European Americans, providing a new understanding of the effects of race on heart disease. The finding could one day help doctors provide more individualized treatment of heart disease and other blood-clot-related illnesses, according to research publishing online November 10th in Nature Medicine.

The finding may also provide an additional explanation for the disparity between outcomes in black and white patients with heart disease, which is the most common killer of white and black Americans. Compared to white patients, blacks have a two-fold increased incidence of heart disease and have a lower long-term survival. The reasons for this racial disparity are complex, and include racial bias, a higher prevalence of traditional risk factors in blacks, and differences in socioeconomic status, management and environment. However, even when these factors are considered, the survival of black heart attack patients is 2 and a half times lower than white patients. This suggests there are yet-to-be identified factors accounting for the racial disparity in heart disease.

“We may need to consider our patient’s race when using certain heart disease therapies,” said lead author of the research Paul Bray, M.D., Director of Thomas Jefferson University’s Cardeza Foundation for Hematologic Research.

Anti-platelet medications, such as aspirin, are commonly prescribed to prevent heart attack or stroke. These medications function by blocking the clot-forming activity of platelets — small cells that normally circulate in the blood stream and congeal around damaged or atherosclerotic blood vessels. The plaques in atherosclerotic vessels can occasionally rupture, causing the formation of a platelet plug that clogs blood vessels and can lead to heart attack or stroke. However, there is considerable variability in how patients respond to these medications, which confounds physicians who must deduce the appropriate drug and proper dose for each patient. Now, researchers from Thomas Jefferson University have identified some of the genetic differences behind these variations, which could help doctors treat racial groups with a more personalized and effective approach.

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