Gender differences in efficacy and safety of antiplatelet strategies for acute coronary syndromes

被引:6
|
作者
Occhipinti, Giovanni [1 ]
Greco, Antonio [1 ]
Angiolillo, Dominick J. J. [2 ]
Capodanno, Davide [1 ]
机构
[1] Univ Catania, Azienda Osped Univ Policlin G Rodol San Marco, Div Cardiol, Catania, Italy
[2] Univ Florida, Coll Med, Div Cardiol, 655 West 8th St, Jacksonville, FL 32209 USA
关键词
Acute coronary syndrome; antiplatelet therapy; dual antiplatelet therapy; gender; pharmacotherapy; sex differences; ELEVATION MYOCARDIAL-INFARCTION; SEX-RELATED DIFFERENCES; RESIDUAL PLATELET REACTIVITY; IN-HOSPITAL MORTALITY; DRUG-ELUTING STENTS; ST-ELEVATION; OPEN-LABEL; ARTERY-DISEASE; DE-ESCALATION; HEART-DISEASE;
D O I
10.1080/14740338.2023.2245331
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
IntroductionDual antiplatelet therapy (DAPT) represents the cornerstone of secondary prevention in patients presenting with acute coronary syndrome (ACS) and undergoing percutaneous coronary intervention. Despite its undisputed efficacy in reducing thrombotic events, DAPT increases the risk of bleeding, which is associated with higher morbidity and mortality. Novel antiplatelet strategies (i.e. in terms of timing, selection of drugs and their combinations, and modulation strategies) have been tested in randomized trials, suggesting the utility of tailored approaches in selected populations (i.e. patients at high bleeding or ischemic risk). It remains uncertain whether the effect of these strategies is influenced by sex.Areas coveredThis narrative review provides an overview of available evidence surrounding sex differences in the efficacy and safety of antiplatelet strategies for ACS and analyzes the potential reasons behind these findings. Relevant content was searched for in PubMed.Expert opinionSignificant differences between women and men exist in terms of clinical presentation, pharmacotherapies, interventional management, and prognosis of ACS. However, these observations do not appear to be attributed to different pharmacodynamic effects of antiplatelet therapies between women and men. Unfortunately, a critical issue depends on women being often underrepresented in clinical trials, leading to a substantial lack of sex-specific evidence.
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页码:669 / 683
页数:15
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