Gender and responses to aspirin and clopidogrel: insights using short thrombelastography.
Gender and responses to aspirin and clopidogrel: insights using short thrombelastography.
There is significant variability in both baseline clotting tendency and response to antiplatelet therapy. Responses are associated with outcome. We have investigated whether differences could explain the increased risk observed in women presenting with coronary artery disease. We have utilized short thrombelastography to assess (i) baseline clotting responses, (ii) response to aspirin and clopidogrel, and (iii) post-treatment platelet reactivity in 48 young volunteers, 22 older patients and 18 patients with previous stent thrombosis. Baseline responses were significantly higher in young women than in men. While there was no difference in response to aspirin, platelet reactivity on aspirin remained higher in women (area under curve at 15 min [AUC15] of arachidonic acid channel 332 ± 122 vs. 172 ± 80, P= 0.04). Young women had less response to clopidogrel (% reduction in AUC15 with adenosine diphosphate [ADP] 36.4 ± 12.4 vs. 64.0 ± 13.2, P < 0.01) in addition to higher post-treatment reactivity (AUC15 of ADP 714 ± 161 vs. 311 ± 146, P < 0.01) compared to men. There were no such differences between male and female patients over 50. However, young women with previous stent thrombosis had among the highest platelet reactivity observed. Compared to men, young women have greater baseline clotting tendency, reduced response to clopidogrel, and greater post-treatment reactivity while on both aspirin and clopidogrel. Differences in clotting tendency and response to antiplatelet therapy may contribute to the excess risk observed in young women but are not observed in older female patients
Gender, Aspirin, Clopidogrel, Thrombelastography
246-252
Hobson, A.
7d245a8e-2a69-417c-81ae-5d8c6b775897
Qureshi, Z.
1d422f0e-fab3-490c-a6d2-7f3829fd4401
Banks, P.
6c559801-5b40-4de6-b440-1b0623d26d76
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
9 November 2009
Hobson, A.
7d245a8e-2a69-417c-81ae-5d8c6b775897
Qureshi, Z.
1d422f0e-fab3-490c-a6d2-7f3829fd4401
Banks, P.
6c559801-5b40-4de6-b440-1b0623d26d76
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Hobson, A., Qureshi, Z., Banks, P. and Curzen, N.
(2009)
Gender and responses to aspirin and clopidogrel: insights using short thrombelastography.
Cardiovascular therapeutics, 27 (4), .
(doi:10.1111/j.1755-5922.2009.00106.x).
Abstract
There is significant variability in both baseline clotting tendency and response to antiplatelet therapy. Responses are associated with outcome. We have investigated whether differences could explain the increased risk observed in women presenting with coronary artery disease. We have utilized short thrombelastography to assess (i) baseline clotting responses, (ii) response to aspirin and clopidogrel, and (iii) post-treatment platelet reactivity in 48 young volunteers, 22 older patients and 18 patients with previous stent thrombosis. Baseline responses were significantly higher in young women than in men. While there was no difference in response to aspirin, platelet reactivity on aspirin remained higher in women (area under curve at 15 min [AUC15] of arachidonic acid channel 332 ± 122 vs. 172 ± 80, P= 0.04). Young women had less response to clopidogrel (% reduction in AUC15 with adenosine diphosphate [ADP] 36.4 ± 12.4 vs. 64.0 ± 13.2, P < 0.01) in addition to higher post-treatment reactivity (AUC15 of ADP 714 ± 161 vs. 311 ± 146, P < 0.01) compared to men. There were no such differences between male and female patients over 50. However, young women with previous stent thrombosis had among the highest platelet reactivity observed. Compared to men, young women have greater baseline clotting tendency, reduced response to clopidogrel, and greater post-treatment reactivity while on both aspirin and clopidogrel. Differences in clotting tendency and response to antiplatelet therapy may contribute to the excess risk observed in young women but are not observed in older female patients
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Published date: 9 November 2009
Keywords:
Gender, Aspirin, Clopidogrel, Thrombelastography
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Local EPrints ID: 79341
URI: http://eprints.soton.ac.uk/id/eprint/79341
ISSN: 1755-5914
PURE UUID: 834aea06-f729-4df1-892e-dadd101c5a59
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Date deposited: 15 Mar 2010
Last modified: 14 Mar 2024 02:50
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Author:
A. Hobson
Author:
Z. Qureshi
Author:
P. Banks
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