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Updated: May 13, 2025
06:47
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
719
Sex Differences in Platelet Response to Common Antiplatelet Medications
Adriana A Rodriguez Alvarez1, Isabella Ferlini Cieri1, Mounika Naidu Boya1
1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA.
Annals of Vascular Surgery
|May 11, 2025
Summary
Women with peripheral artery disease on mono antiplatelet therapy show increased platelet reactivity. Dual antiplatelet therapy eliminated these sex differences, suggesting tailored antiplatelet strategies may be beneficial.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Pharmacology
Background:
- Sex differences in platelet aggregation within peripheral artery disease (PAD) populations are not well understood.
- Platelet reactivity is crucial in PAD management and cardiovascular event prevention.
Purpose of the Study:
- To investigate the impact of antiplatelet therapy on platelet reactivity stratified by sex in PAD patients.
- To determine if sex influences the efficacy of mono antiplatelet therapy (MAPT) versus dual antiplatelet therapy (DAPT).
Main Methods:
- A prospective cohort study included 261 PAD patients undergoing revascularization.
- Patients received either MAPT or DAPT (aspirin plus clopidogrel/ticagrelor).
- Thromboelastography (TEG) and platelet mapping assessed platelet function pre- and post-operatively, with statistical analysis for sex differences and mediation effects.
Main Results:
- Women on MAPT exhibited significantly higher fibrinogen-related clot strength, greater platelet aggregation, and lower platelet inhibition compared to men.
- No significant sex differences in platelet reactivity were observed in patients receiving DAPT.
- Sex did not confound or mediate the effect of antiplatelet therapy on TEG parameters.
Conclusions:
- Sex-based disparities in platelet reactivity exist in PAD patients treated with MAPT.
- DAPT appears to normalize platelet reactivity between sexes in this population.
- Consideration of more potent antiplatelet strategies for women with PAD may be warranted to mitigate observed differences.
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