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Sex-Specific Platelet Activation Through Protease-Activated Receptors Reverses in Myocardial Infarction

Beom Soo Kim1, David S Auerbach2, Hamza Sadhra1

  • 1Aab Cardiovascular Research Institute, University of Rochester School of Medicine, Rochester, New York (B.S.K., H.S., A.M., D.Q.R., S.T., C.N.M., S.J.C.).

Arteriosclerosis, Thrombosis, and Vascular Biology
|November 12, 2020
PubMed

Insights

Platelets show sex-specific reactivity, with females exhibiting higher activation via protease-activated receptors (PARs) in healthy states. This pattern reverses during myocardial infarction (MI), suggesting tailored antiplatelet therapies may be needed.

Area of Science:

  • Cardiovascular Biology
  • Platelet Physiology
  • Sex Differences in Medicine

Background:

  • Platelet function can vary between healthy individuals and patients with cardiovascular conditions.
  • Understanding receptor-mediated platelet activation is crucial for cardiovascular disease management.

Purpose of the Study:

  • To evaluate sex-specific differences in platelet activation through specific receptors.
  • To compare platelet activation in healthy men and women versus patients with ST-segment-elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction (NSTEMI).

Main Methods:

  • Analysis of platelet activation via specific receptors in healthy humans and a murine myocardial infarction (MI) model.
  • Multivariate regression analyses to identify predictors of platelet activation.
  • Comparison of platelet reactivity between sexes in healthy states and during MI.

Main Results:

  • Healthy female platelets showed higher reactivity via protease-activated receptors (PARs) compared to males.
  • Male sex and NSTEMI were independent predictors of enhanced PAR1 activation in human platelets.
  • Platelet PAR1 signaling decreased in women and increased in men during MI, opposite to healthy conditions. Similar cross-species trends were observed in mice.

Conclusions:

  • Sex-specific platelet signaling is a conserved phenomenon across species.
  • The divergent platelet phenotype during MI suggests the need for prospective evaluation of sex-specific antiplatelet drug regimens.
Abstract

Keywords:
femalemyocardial infarctionplatelet activationregression analysisthrombin

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