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首页> 外文期刊>Platelets >Sex differences in platelet reactivity in patients with myocardial infarction treated with triple antiplatelet therapy-results from assessing platelet activity in coronary heart disease (APACHE)
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Sex differences in platelet reactivity in patients with myocardial infarction treated with triple antiplatelet therapy-results from assessing platelet activity in coronary heart disease (APACHE)

机译：三重抗血小板治疗患者心肌梗死患者血小板反应性的性差异 - 评估冠心病血小板活性（Apache）

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)Several earlier studies have reported increased risk of bleeding in women with myocardial infarction, (MI) compared to men. The reasons for the observed difference are incompletely understood, but one suggested explanation has been excess dosing of antithrombotic drugs in women. The aim of this prospective observational study was to assess sex differences in platelet activity in patients treated with three different platelet inhibitors. We recruited 125 patients (37 women and 88 men) with MI, scheduled for coronary angiography. All patients received clopidogrel and aspirin. A subgroup of patients received glycoprotein (GP) IIb/IIIa-inhibitor. Platelet aggregation in whole blood was assessed at several time points, using impedance aggregometry. SolubleP-selectin was measured 3 days after admission. There were no significant differences between women and men in baseline features or comorbidities except higher frequency of diabetes, lower hemoglobin value, and lower estimated glomerular filtration rate, in women on admission. We observed significantly more in-hospital bleeding events in women compared to men (18.9% vs. 6.8%,p= .04). There were no differences in platelet aggregation using three different agonists, reflecting treatment effect of GPIIb/IIIa-inhibitors, clopidogrel, and aspirin, 6-8 hours, 3 days, 7-9 days, or 6 months after loading dose. Moreover, there was no significant difference in solubleP-selectin. The main finding of this study was a consistent lack of difference between the sexes in platelet aggregation, using three different agonists at several time-points. Our results do not support excess dosing of anti-platelet drugs as a major explanation for increased bleeding risk in women.
机译：)几项早期研究报告，与男性相比，女性心肌梗死（MI）患者的出血风险增加。观察到的差异的原因尚不完全清楚，但有一种解释是女性服用了过量的抗血栓药物。这项前瞻性观察研究的目的是评估接受三种不同血小板抑制剂治疗的患者血小板活性的性别差异。我们招募了125名MI患者（37名女性和88名男性），计划进行冠状动脉造影。所有患者均服用氯吡格雷和阿司匹林。一组患者接受糖蛋白（GP）IIb/IIIa抑制剂治疗。在几个时间点，使用阻抗聚集仪评估全血中的血小板聚集。入院3天后测量可溶性选择素。女性和男性在基线特征或共病方面没有显著差异，除了入院时女性糖尿病发生率较高、血红蛋白值较低和估计肾小球滤过率较低。我们观察到女性住院出血事件明显多于男性（18.9%比6.8%，p=0.04）。使用三种不同的激动剂时，血小板聚集没有差异，反映了GPIIb/IIIa抑制剂、氯吡格雷和阿司匹林在负荷剂量后6-8小时、3天、7-9天或6个月的治疗效果。此外，可溶性选择素没有显著差异。这项研究的主要发现是，在几个时间点使用三种不同的激动剂时，性别之间的血小板聚集性一直没有差异。我们的研究结果不支持过量服用抗血小板药物作为女性出血风险增加的主要原因。

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