Gender‐related differences in antiplatelet treatment patterns and outcome: Insights from the GReekAntiPlatElet Registry

Xanthopoulou, Ioanna; Davlouros, Periklis; Deftereos, Spyridon; Hamilos, Michalis; Sitafidis, George; Kanakakis, Ioannis; Vavouranakis, Manolis; Goudevenos, John; Lekakis, John; Alexopoulos, Dimitrios

doi:10.1111/1755-5922.12270

Cited by 15 publications

(10 citation statements)

References 16 publications

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“…Probably, the fundamental explanation for this data is the fact that women possess a higher hemorrhagic risk, as consistently described in medical publications 3,6,15,17,23,24 . In a recent prospective study of 1214 patients undergoing catheterization in a tertiary care Spanish hospital 25 , no significant gender-related differences were found in the treatment and prognosis of these patients.…”

Section: Discussionmentioning

confidence: 78%

“…At discharge, although the differences were less evident and ticagrelor was the drug of choice in both genders, higher use of clopidogrel persisted in women. Evidence in this regard is growing, with another recent study that obtained similar results: clopidogrel is prescribed to a larger extent in women than in men 23 . In addition, in this cohort, there was a higher use of glycoprotein IIb/IIIa inhibitors in men (16.2 vs. 32.3%), which is also an indicator of the more radical antithrombotic treatment used in males.…”

Section: Discussionmentioning

confidence: 85%

See 1 more Smart Citation

Sex-specific differences in antithrombotic therapy and prognosis in patients with acute coronary syndrome treated with stent

Jimeno-Sánchez¹,

Fuertes-Ferre²,

Ruiz-Aranjuelo³

et al. 2020

ACME

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 85%

Sex-specific differences in antithrombotic therapy and prognosis in patients with acute coronary syndrome treated with stent

Jimeno-Sánchez¹,

Fuertes-Ferre²,

Ruiz-Aranjuelo³

et al. 2020

ACME

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“…Concerning the subgroup analyses, ticagrelor seemed to increase the major bleeding complications among female as opposed to male patients. Although the findings from subgroup analyses could be misleading, 13 conflicting and limited data from other trials call for high-quality studies to investigate the gender differences in bleeding risk with ticagrelor treatment, especially in Asian population 9, 28, 29…”

Section: Discussionmentioning

confidence: 99%

Ticagrelor for Asian patients with acute coronary syndrome in real-world practice: A systematic review and meta-analysis of observational studies

Galimzhanov

Azizov

2019

Indian Heart Journal

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ObjectiveWe aimed to assess the efficacy and safety of ticagrelor compared to clopidogrel in Asian patients with acute coronary syndrome (ACS) in real-world practice.MethodsPubMed, Web of Science and Scopus databases were searched systematically to obtain relevant Asian observational studies.ResultsThe meta-analysis included six studies with 27959 participants. Compared with clopidogrel, ticagrelor was significantly beneficial in prevention of major adverse cardiac events (MACCEs) (OR=0.62; 95% CI: 0.46-0.83, I2=69%, p=0.001) mainly driven by reducing stroke (OR=0.62; 95% CI: 0.49-0.78, I2=0%, p<0.001). No differences were found between ticagrelor and clopidogrel in the risk of cardiovascular mortality (OR=0.66; 95% CI: 0.41-1.06, I2=0%, p=0.09), target vessel revascularization (OR=0.53; 95% CI: 0.21-1.35, I2=82%, p=0.18), major bleeding (OR=1.11; 95% CI: 0.62-2.00, I2=75%, p=0.73), and net adverse clinical and cerebral events (OR=0.76; 95% CI: 0.55-1.04, I2=78%, p=0.09). However, ticagrelor significantly increased the incidence of major/minor (OR=1.73; 95% CI: 1.36-2.21, I2=0%, p<0.001) and minor bleeding (OR=1.73; 95% CI: 1.29-2.32, I2=0%, p<0.001). Sensitivity analyses did not find consistent effect of ticagrelor on prevention of all-cause death and myocardial infarction.ConclusionThis meta-analysis suggested that ticagrelor might reduce the risk of MACCEs mainly by reducing stroke in Asian patients with ACS without increasing the rates of major bleeding. Ticagrelor did not show a significant effect on other parts of MACCEs. Considerable increase in the risk of major/minor and minor bleeding was observed in ticagrelor compared with clopidogrel users. Further high-quality studies are required to support these findings.

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“…10,11 However, the vast majority of those studies were performed in patients treated with aspirin and/or clopidogrel, and the role of the newer, more potent P 2 Y 12 inhibitors, such as ticagrelor and prasugrel, is still partially unknown. 2,12,13 Moreover, it is still unclear whether or not gender-related differences in clinical outcome still persist in contemporary practice and what would be its impact. Thus, aim of the present study was to investigate whether gender influences the choice of antiplatelet treatment upon admission for ACS and its impact on 1-year clinical outcome from the real-world, multicenter, Italian registry START ANTIPLATELET.…”

Section: Introductionmentioning

confidence: 99%

Gender-Related Differences in Antiplatelet Therapy and Impact on 1-Year Clinical Outcome in Patients Presenting With ACS: The START ANTIPLATELET Registry

et al. 2018

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We investigated whether gender influences antiplatelet treatment in patients with acute coronary syndrome (ACS). The primary end point was major adverse cardiac and cerebrovascular events (MACCEs), a composite of death, myocardial infarction (MI), stroke, or target vessel revascularization. The coprimary end point was net adverse cardiac and cerebrovascular events (NACEs), based on MACCE plus major bleeding. From January 2014 to December 2016, 840 consecutive patients with ACS who completed 1-year follow-up were enrolled, 625 (74%) males and 215 (26%) females. Percutaneous coronary interventions (PCI) and drug-eluting stents (DES) were more often used in males (PCI: 532 [87%] vs 168 [80%], P = .02 and DES 474 [76%] vs 143 [66%], P = .01). Males were more often treated with dual antiplatelet therapy (DAPT; 94% vs 88%, P = .01). In DAPT, ticagrelor was the most prevalent strategy, regardless of gender (47% vs 49%, P = .68); clopidogrel was preferred in women (42% vs 33%, P = .04); and prasugrel was preferred in men (11% vs 17%, P = .04). At multivariate analysis, MACCE and NACE were similar between genders. Therefore, although PY inhibitor choice in DAPT might be influenced by gender, a DAPT choice, tailored by balancing the ischemic/bleeding risk, has a similar clinical outcome irrespective of gender.

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Gender‐related differences in antiplatelet treatment patterns and outcome: Insights from the GReekAntiPlatElet Registry

Abstract: In a contemporary "real-life" cohort of patients with ACS treated with PCI and focusing on antiplatelet treatment 1-year ischemic outcome does not differ by gender, while women do present more frequently not actionable bleeding events.

Cited by 15 publications

References 16 publications

Sex-specific differences in antithrombotic therapy and prognosis in patients with acute coronary syndrome treated with stent

Sex-specific differences in antithrombotic therapy and prognosis in patients with acute coronary syndrome treated with stent

Ticagrelor for Asian patients with acute coronary syndrome in real-world practice: A systematic review and meta-analysis of observational studies

Gender-Related Differences in Antiplatelet Therapy and Impact on 1-Year Clinical Outcome in Patients Presenting With ACS: The START ANTIPLATELET Registry

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