title: Platelet function and long-term antiplatelet therapy in women: is there a gender-specificity? A 'state-of-the-art' paper.
abstract: Although the female gender is generally less represented in cardiovascular studies, observational and randomized investigations suggest that-compared with men-women may obtain different benefits from antiplatelet therapy. Multiple factors, including hormonal mechanisms and differences in platelet biology, might contribute to such apparent gender peculiarities. The thrombotic and bleeding risks, as well as outcomes after a cardiovascular event, appear to differ between genders, partly in relation to differences in age, comorbidities and body size. Equally, the benefits of antiplatelet therapy may differ in women compared with men in different vascular beds, during primary or secondary prevention and according to the type of an antiplatelet agent used. This document is an attempt to bring together current evidence, clinical practices and gaps of knowledge on gender-specific platelet function and antiplatelet therapy. On the basis of the available data, we provide suggestions on current indications of antiplatelet therapy for cardiovascular prevention in women with different clinical features; no strong recommendation may be given because the available data derive from observational studies or post hoc/subgroup analyses of randomized studies without systematic adjustments for baseline risk profiles.
authors.affiliation: Department of Cardiovascular Science, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 , Rome, Italy g.patti@unicampus.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Patti
authors.affiliation: Institute of Cardiology, SS Annunziata Hospital, Chieti, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caterina
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Abbate
authors.affiliation: Department of Cardiovascular Science, Catholic University, Rome, Italy.
authors.forename: Felicita
authors.initials: F
authors.lastname: Andreotti
authors.affiliation: Department of Cardiovascular Science, Catholic University, Rome, Italy.
authors.forename: Luigi Marzio
authors.initials: LM
authors.lastname: Biasucci
authors.affiliation: Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, Caserta, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabrò
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cioni
authors.affiliation: Internal Medicine, University of Chieti, Chieti, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Davì
authors.affiliation: Department of Cardiovascular Science, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 , Rome, Italy.
authors.forename: Germano
authors.initials: G
authors.lastname: Di Sciascio
authors.affiliation: Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, Caserta, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Golia
authors.affiliation: Division of Cardiology, Department of Cardiothoracic Sciences, Second University of Naples, S. Anna and S. Sebastiano Hospital, Caserta, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Golino
authors.affiliation: Institute of Cardiology, SS Annunziata Hospital, Chieti, Italy.
authors.forename: Gelsomina
authors.initials: G
authors.lastname: Malatesta
authors.affiliation: Department of Cardiovascular Science, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 , Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Mangiacapra
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Marcucci
authors.affiliation: Department of Cardiovascular Science, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 , Rome, Italy.
authors.forename: Annunziata
authors.initials: A
authors.lastname: Nusca
authors.affiliation: Cardiology Unit, Madonna del Soccorso Hospital and Politecnica Delle Marche University, San Benedetto del Tronto, Italy.
authors.forename: Vito Maurizio
authors.initials: VM
authors.lastname: Parato
authors.affiliation: Department of Cardiac Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pengo
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence and Patologia Medica Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Prisco
authors.affiliation: Department of Experimental Medicine, Sapienza University, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Pulcinelli
authors.affiliation: Institute of Cardiology, SS Annunziata Hospital, Chieti, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Renda
authors.affiliation: Department of Cardiovascular Science, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 , Rome, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Ricottini
authors.affiliation: Institute of Cardiology, SS Annunziata Hospital, Chieti, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Ruggieri
authors.affiliation: Internal Medicine, University of Chieti, Chieti, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Santilli
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sofi
authors.affiliation: Institute of Cardiology, SS Annunziata Hospital, Chieti, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Zimarino
mesh_terms: D001792:Blood Platelets / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control; D017281:Cost of Illness; D003925:Diabetic Angiopathies / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D012727:Sex Characteristics; D020521:Stroke / Q000517:prevention & control; D013927:Thrombosis / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Antiplatelet therapy; Gender differences; Men; Platelets; Thrombosis; Women