Sex difference in antithrombotic effect of aspirin.

Spranger, Matthias; Aspey, BS; Harrison, M. J. G.

doi:10.1161/01.str.20.1.34

Cited by 77 publications

(33 citation statements)

References 19 publications

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“…For this reason, the bioavailability of acetylsalicylic acid in women under hormonal contraception seems to be similar to men. It has been also highlighted the importance of sex hormone-mediated modulation of the aspirin activity, by the evidence that the rate of aspirin absorption is declined during the menstrual mid-cycle, and the effects of exogenous hormones on the pharmacokinetics of aspirin have confirmed this finding [36] 3. Gender-difference in anti-platelet drug response…”

Section: Gender-difference In Anti-platelet Pharmacodynamics and Pharmentioning

confidence: 99%

Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment

Giosia

Passacquale

Petrarca

et al. 2017

Pharmacological Research

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Cardiovascular disease (CVD) represents the leading cause of death worldwide, and equally affects both sexes although women develop disease at an older age than men. A number of clinical evidence has identified the female sex as an independent factor for poor prognosis, with the rate of mortality and disability following an acute cardiovascular (CV) event being higher in women than men. It has been argued that the different level of platelet reactivity between sexes may account for a different responsiveness to anti-platelet therapy, with consequent important implications on clinical outcomes. However, conclusive evidence supporting the concept of a gender-dependent effectiveness of platelet inhibitors are lacking. On the contrary, sex-related dissimilarities have been evidenced in cardiovascular patients in terms of age of presentation, comorbidities such as obesity, diabetes and renal disease, and a different pharmacological approach to and effectiveness in controlling classical cardiovascular risk factors such as hypertension, glucose profile and lipid dysmetabolism. All these factors could place women at an increased level of cardiovascular risk compared to men, and may concur to an enhanced pro-thrombogenic profile. The purpose of this manuscript is to provide an overview of gender-related differences in cardiovascular treatment, in order to highlight the need to improve the pharmacological prophylaxis adopted in women through a more accurate evaluation of the overall cardiovascular risk profile with consequent establishment of a more effective and targeted anti-thrombotic strategy which is not limited to the use of antiplatelet agents.

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Section: Gender-difference In Anti-platelet Pharmacodynamics and Pharmentioning

confidence: 99%

Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment

Giosia

Passacquale

Petrarca

et al. 2017

Pharmacological Research

View full text Add to dashboard Cite

show abstract

“…An in vitro study evaluating whole blood platelet aggregation revealed that the antithrombotic effect of aspirin was significantly greater in men, most likely because of the difference in testosterone levels. 13 In contrast, an estrogen-associated reduction in the number of pituitary receptors for corticosteroids has been observed in female rats. 14 No study has yet examined the effect of gender on corticosteroid pharmacodynamics in humans.…”

mentioning

confidence: 97%

Gender-based effects on methylprednisolone pharmacokinetics and pharmacodynamics

Lew

Ludwig

Milad

et al. 1993

Clin Pharmacol Ther

155

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The pharmacokinetics and selected pharmacodynamic responses to methylprednisolone were investigated in six men and six premenopausal women after a dose of 0.6 mg/kg ideal body weight. Women (luteal phase) exhibited a greater methylprednisolone clearance (0.45 versus 0.29 L/hr/kg) and shorter elimination half-life (1.7 versus 2.6 hours) than men. The volume of distribution of methylprednisolone was similar when normalized for ideal body weight. Pharmacodynamic models were used to examine the methylprednisolone suppressive effects on cortisol secretion and basophil and helper T lymphocyte trafficking. A significantly smaller 50% inhibitory concentration (IC 50 ) value (0.1 versus 1.7 ng/ml) was seen in the women for suppression of cortisol secretion, indicating increased sensitivity. However, the area under the concentration-time curve of effect was similar for both groups. The IC 50 values for effects of methylprednisolone on basophil trafficking related to estradiol concentrations in a log-linear fashion in women, with increased sensitivity found at higher estradiol concentrations. Men displayed a greater 24-hour net suppression in blood basophil numbers, but no difference was observed in net cortisol and helper T lymphocyte suppression between the sexes. These findings suggest that methylprednisolone dosages should be based on ideal body weight. Although women are more sensitive to methylprednisolone as measured by cortisol suppression, they eliminate the drug more quickly, generally producing a similar net response.Male subjects typically have been used in most drug studies. However, the findings of these studies are applied clinically to both male and female patients, despite their physiologic differences. Of the studies that have enrolled both men and women, most fail to analyze their findings by gender and instead treat all the subjects as one homogeneous group. 1 This bias in clinical research has been of concern within the health professions. [2][3][4] The literature currently lacks guidelines regarding dosing regimens based on gender.Copyright © 1993 by Mosby-Year Book, Inc.Reprint requests: William J. Jusko, PhD, Hochstetter 565, School of Pharmacy, State University or New York at Buffalo, Buffalo, NY 14260. Presented at the Ninety-fourth Annual Meeting of the American Society for Clinical Pharmacology and Therapeutics, March 24-26, 1993, Honolulu, Hawaii (Abstract: Clin Pharmacol Ther 1993;53:183). NIH Public Access Author ManuscriptClin Pharmacol Ther. Author manuscript; available in PMC 2014 October 23. Published in final edited form as:Clin Pharmacol Ther. 1993 October ; 54(4): 402-414. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptGender-related differences in disposition have been observed for numerous drugs. The total and unbound clearance of diazepam, which undergoes oxidative metabolism, was found to be greater in women. 5 Clearance of oxazepam (total and unbound) 6 and acetaminophen, 7 both of which undergo glucuronide conjugation, is significantly greater ...

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“…1 These age and gender bias could influence the results. 38,39 In conclusion, P-selectin expression, but not activated GPIIb/IIIa, was augmented in ADP-activated platelets in patients in the active stage of TA with conventional therapy. Platelet P-selectin may play an important role in the inflammatory and thrombotic disease process associated with intractable TA by inducing platelet -leukocyte interactions.…”

Section: Discussionmentioning

confidence: 85%

P-Selectin Expression, but not GPIIb/IIIa Activation, is Enhanced in the Inflammatory Stage of Takayasu's Arteritis

Kasuya

Kishi

Isobe

et al. 2006

Circ J

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Sex difference in antithrombotic effect of aspirin.

Cited by 77 publications

References 19 publications

Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment

Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment

Gender-based effects on methylprednisolone pharmacokinetics and pharmacodynamics

P-Selectin Expression, but not GPIIb/IIIa Activation, is Enhanced in the Inflammatory Stage of Takayasu's Arteritis

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