Gender-based differences in hemostatic responses

Recent reports indicate increased mortality in women owing to cardiovascular diseases necessitating more gender-based studies. It is hypothesized that women have variable hemostatic responses to anticoagulant drugs.

The hemostatic responses in healthy males (n = 10) and females (n = 10) were evaluated by performing various assays in the presence of anticoagulant drugs. Citrated whole blood from healthy volunteers (n = 20) was supplemented with rivaroxaban (final concentration [FC] = 0.3 µg/ml) and enoxaparin (FC =5 µg/ml).

Differences between males and females were noted in the whole blood activated partial thromboplastin time (p = 0.0442) and Heptest^® (p = 0.0345) assays in the saline control values. In the plasma system, rivaroxaban at a FC of 0.3 µg/ml and enoxaparin at 5 µg/ml showed a gender-based difference in the Heptest (p = 0.0423). Females showed faster fibrin formation than males. In the plasma system, plasminogen activator inhibitor-1 and domain-dimer assays (American Diagnostica, CT, USA) were performed with domain-dimer showing differences (p = 0.035). In the von Willebrand factor multimers, only band 5 showed differences (p = 0.032). Gender-based differences were observed.

Careful adjustment of the dosages of anticoagulant drugs may be necessary to avoid bleeding or thrombosis.