gender-based differences in platelet function and platelet reactivity to p2y12 inhibitors.

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ID: 130350
2019
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Abstract
BACKGROUND:Gender influences platelet biology. Women have a larger platelet count, but gender-based differences in platelet function remain debated. We performed a study addressing gender-based differences in platelet function using point-of-care platelet function tests (PFT). METHODS:The patient population consisted of 760 cardiac surgery patients where preoperative PFT (multiple-electrode aggregometry [MEA]) were available. Platelet count and function at the ADPtest and TRAPtest were compared in the overall population and separately in patients with or without residual effects of P2Y12 inhibitors. RESULTS:Women had a significantly (P = 0.001) higher platelet count but a non-significantly higher platelet reactivity to ADP. In clopidogrel-treated patients, the platelets ADP reactivity was significantly (P = 0.031) higher in women, and platelet count was the main determinant of platelet hyper-reactivity. Within patients under full clopidogrel effects, women with a platelet count ≥ 200,000 cells/μL had a significantly (P = 0.023) higher rate of high-on-treatment platelet reactivity (HTPR, 45.5%) with respect to males with a platelet count < 200,000 cells/μL (11.9%), with a relative risk of 6.2 (95% confidence interval 1.4-29). CONCLUSIONS:Our findings confirm that women have a larger platelet count than men, and that this is associated to a trend towards a higher platelet reactivity. HTPR is largely represented in women with a high platelet count. This generates the hypothesis that women requiring P2Y12 inhibitors could potentially benefit from larger doses of drug or should be treated with anti-platelet agents with a low rate of HTPR.
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ranucci2019plosgender-based Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Marco Ranucci;Tommaso Aloisio;Umberto Di Dedda;Lorenzo Menicanti;Carlo de Vincentiis;Ekaterina Baryshnikova;Surgical and Clinical Outcome REsearch (SCORE) group
Journal ensaio pesquisa em educação em ciências
Year 2019
DOI
10.1371/journal.pone.0225771
URL
https://doi.org/10.1371/journal.pone.0225771
Keywords
medicinescience

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