Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment

Paolo Di Giosia, G. Passacquale, M. Petrarca, P. Giorgini, A.M. Marra, A. Ferro

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

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 anti-platelet agents. © 2017 Elsevier Ltd
Original languageEnglish
Pages (from-to)36-47
Number of pages12
JournalPharmacological Research
Volume119
DOIs
Publication statusPublished - 2017

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Blood Platelets
Pharmacology
Platelet Aggregation Inhibitors
Therapeutics
Comorbidity
Cause of Death
Cardiovascular Diseases
Obesity
Hypertension
Kidney
Lipids
Glucose
Mortality

Keywords

  • Antiplatelet treatment
  • Cardiovascular disease
  • Gender
  • Platelet

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Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment. / Di Giosia, Paolo; Passacquale, G.; Petrarca, M.; Giorgini, P.; Marra, A.M.; Ferro, A.

In: Pharmacological Research, Vol. 119, 2017, p. 36-47.

Research output: Contribution to journalArticle

Di Giosia, Paolo ; Passacquale, G. ; Petrarca, M. ; Giorgini, P. ; Marra, A.M. ; Ferro, A. / Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment. In: Pharmacological Research. 2017 ; Vol. 119. pp. 36-47.
@article{57e5bda056694cf88584eff831db7f71,
title = "Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment",
abstract = "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 anti-platelet agents. {\circledC} 2017 Elsevier Ltd",
keywords = "Antiplatelet treatment, Cardiovascular disease, Gender, Platelet",
author = "{Di Giosia}, Paolo and G. Passacquale and M. Petrarca and P. Giorgini and A.M. Marra and A. Ferro",
note = "Export Date: 21 March 2017 CODEN: PHMRE Correspondence Address: Ferro, A.; King's College London, Franklin-Wilkins Building, 150 Stamford Street, United Kingdom; email: albert.ferro@kcl.ac.uk References: Mozaffarian, D., Benjamin, E.J., Go, A.S., Arnett, D.K., Blaha, M.J., Cushman, M., Executive summary heart disease and stroke Statistics–2016 update: a report from the American Heart Association (2016) Circulation, 133, pp. e38-e360; Lopez, A.D., Mathers, C.D., Ezzati, M., Jamison, D.T., Murray, C.J., Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data (2006) Lancet, 367, pp. 1747-1757; WHO, Global Atlas on cardiovascular disease prevention and control, , http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/; Basili, S., Raparelli, V., Proietti, M., Tanzilli, G., Franconi, F., Impact of sex and gender on the efficacy of antiplatelet therapy: the female perspective (2015) J. Atheroscler. 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year = "2017",
doi = "10.1016/j.phrs.2017.01.025",
language = "English",
volume = "119",
pages = "36--47",
journal = "Pharmacological Research",
issn = "1043-6618",
publisher = "Academic Press",

}

TY - JOUR

T1 - Gender differences in cardiovascular prophylaxis: Focus on antiplatelet treatment

AU - Di Giosia, Paolo

AU - Passacquale, G.

AU - Petrarca, M.

AU - Giorgini, P.

AU - Marra, A.M.

AU - Ferro, A.

N1 - Export Date: 21 March 2017 CODEN: PHMRE Correspondence Address: Ferro, A.; King's College London, Franklin-Wilkins Building, 150 Stamford Street, United Kingdom; email: albert.ferro@kcl.ac.uk References: Mozaffarian, D., Benjamin, E.J., Go, A.S., Arnett, D.K., Blaha, M.J., Cushman, M., Executive summary heart disease and stroke Statistics–2016 update: a report from the American Heart Association (2016) Circulation, 133, pp. e38-e360; Lopez, A.D., Mathers, C.D., Ezzati, M., Jamison, D.T., Murray, C.J., Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data (2006) Lancet, 367, pp. 1747-1757; WHO, Global Atlas on cardiovascular disease prevention and control, , http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/; Basili, S., Raparelli, V., Proietti, M., Tanzilli, G., Franconi, F., Impact of sex and gender on the efficacy of antiplatelet therapy: the female perspective (2015) J. Atheroscler. 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PY - 2017

Y1 - 2017

N2 - 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 anti-platelet agents. © 2017 Elsevier Ltd

AB - 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 anti-platelet agents. © 2017 Elsevier Ltd

KW - Antiplatelet treatment

KW - Cardiovascular disease

KW - Gender

KW - Platelet

U2 - 10.1016/j.phrs.2017.01.025

DO - 10.1016/j.phrs.2017.01.025

M3 - Article

VL - 119

SP - 36

EP - 47

JO - Pharmacological Research

JF - Pharmacological Research

SN - 1043-6618

ER -