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Gender and Anti-thrombotic Therapy: from Biology to Clinical Implications

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Abstract

Cardiovascular diseases actually remain the leading cause of death and morbidity in Western countries, and it is the most common cause of death in American women accounting for about one third of all deaths. Women remain underrepresented in published trial literature relative to their disease prevalence. Strong evidence do exists demonstrating gender differences in efficacy (ischemic risk) and safety (bleeding risk) associated with antithrombotic treatment, mostly related to different values of body mass, and renal function in women than men. Several data show a higher platelet reactivity in females and a higher prevalence of high platelet reactivity on aspirin and clopidogrel therapy. In primary prevention, the use of aspirin is associated with a higher reduction of risk for ischemic stroke in females and for myocardial infarction in males. In the setting of ACS, female gender is associated with a significantly higher risk of bleeding. In summary, there are some gender-related aspects of guidance in the complex spectrum of the net clinical benefit related to antithrombotic treatment.

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Acknowledgments

We thank Prof. Fiorenzo Ugolini for his contribution to the revision of the manuscript.

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  1. Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50050, Florence, Italy

    Rossella Marcucci, Gabriele Cioni, Betti Giusti, Cinzia Fatini, Lorenza Rossi, Maddalena Pazzi & Rosanna Abbate

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  1. Rossella Marcucci
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Correspondence to Rossella Marcucci.

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Associate Editor Emanuele Barbato oversaw the review of this article

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Marcucci, R., Cioni, G., Giusti, B. et al. Gender and Anti-thrombotic Therapy: from Biology to Clinical Implications. J. of Cardiovasc. Trans. Res. 7, 72–81 (2014). https://doi.org/10.1007/s12265-013-9534-4

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