Platelet Reactivity and Sex Differences: Clinical Implications for Women

Area of Science:

• * Hematology and Cardiovascular Medicine
• * Platelet Biology and Thrombosis

Background:

• * Platelets are crucial for hemostasis and thrombosis, but their overactivation leads to arterial thrombotic events.
• * Current antiplatelet therapies, while vital for secondary prevention, do not fully address biological heterogeneity (sex, age, disease context).
• * Underrepresentation of women in clinical trials and limitations of preclinical models hinder sex-specific treatment optimization.

Purpose of the Study:

• * To review current antiplatelet strategies, focusing on mechanisms, clinical use, and limitations.
• * To highlight sex-specific considerations and the potential for personalized antiplatelet therapy.
• * To explore emerging therapeutic approaches for refined platelet inhibition.

Main Methods:

• * State-of-the-art review of existing literature on antiplatelet therapy.
• * Examination of platelet signal transduction mechanisms.
• * Analysis of clinical indications and limitations of preclinical and clinical studies.

Main Results:

• * Aspirin and P2Y12 receptor antagonists are standard secondary prevention treatments.
• * Lack of sex-specific data limits precise efficacy and bleeding risk assessment in women.
• * Preclinical models often do not reflect in vivo platelet interactions.

Conclusions:

• * Advancing antiplatelet therapy requires integrating mechanistic platelet biology with diverse clinical data.
• * Standardized platelet phenotyping and disease-specific approaches are essential.
• * Personalized antiplatelet strategies must account for altered platelet function in health and vascular disease.