Platelet biology and response to antiplatelet therapy in women: Implications for the development and use of antiplatelet pharmacotherapies for cardiovascular disease

Tracy Y. Wang, Dominick J. Angiolillo, Mary Cushman, Marc S. Sabatine, Paul F. Bray, Susan S. Smyth, Harold L. Dauerman, Patricia A. French, Richard C. Becker

Research output: Contribution to journalReview articlepeer-review

68 Scopus citations

Abstract

Women are underrepresented in cardiovascular studies, even as their preponderance in the aging population steadily increases. Although concerns have been raised about the differential benefit of antiplatelet medications for women, the propensity for increased bleeding among women has also been recognized. A better understanding of the factors contributing to the observed sex-related differences in platelet biology is warranted. These factors include differences in the frequency and expression of genetic polymorphisms affecting platelet responsiveness to agonists (with and without antiplatelet therapies), which might be obtained through population-based studies and in large controlled clinical trials; inflammatory marker levels and their influence on atherothrombotic risk, and the role of specific hormones in mediating platelet activation and function. Knowledge gained about these mechanistic factors might inform the development of sex-specific antithrombotic treatment regimens that confer optimized safety and efficacy.

Original languageEnglish
Pages (from-to)891-900
Number of pages10
JournalJournal of the American College of Cardiology
Volume59
Issue number10
DOIs
StatePublished - Mar 6 2012

Bibliographical note

Funding Information:
The 2010 Platelet Colloquium was supported by unrestricted educational grants from AstraZeneca , Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership , Daiichi Sankyo/Eli Lilly USA, LLC, Merck Research Laboratories , Regado Biosciences, Inc. , and The Medicines Company . These companies had no role in the development of the manuscript. Participants in the 2010 Platelet Colloquium are listed in the Online Appendix . Dr. Wang has received grant support from BMS/Sanofi Partnership , Daiichi/Eli Lilly , Schering-Plough (now Merck) , The Medicines Company , Canyon Pharmaceuticals , Heartscape Inc. ; and has received honoraria from AstraZeneca, Medco Inc., and the American College of Cardiology Foundation. Dr. Angiolillo has received grant support from AstraZeneca , BMS/Sanofi Partnership , Daiichi/Eli Lilly , Johnson & Johnson , Portola Pharmaceuticals , Schering Corporation , The Medicines Company , GlaxoSmithKline , Otsuka , Accumetrics , and Eisai , received honoraria from AstraZeneca, BMS/Sanofi Partnership, Daiichi/Eli Lilly, Portola Pharmaceuticals, and The Medicines Company; and consulting fees from AstraZeneca, BMS/Sanofi Partnership, Daiichi/Eli Lilly, Portola Pharmaceuticals, The Medicines Company, Sanofi-Aventis, Portola, Novartis, Medicure, Accumetrics, Arena Pharmaceuticals, Abbott Vascular, AstraZeneca, Merck, and Evolva. Dr. Sabatine has received research grant support from AstraZeneca , BMS/Sanofi-Aventis , Daiichi-Sankyo , diaDexus , and Schering-Plough ; is on the scientific advisory boards of BMS/Sanofi-Aventis, Daiichi-Sankyo/Lilly, Eli Lilly, and Sanofi-Aventis; and has received other research support from Nanosphere. Dr. Smyth has received grant support from AstraZeneca , Boehringer Ingelheim , Daiichi/Eli Lilly , Schering Corporation , and The Medicines Company ; and her work is supported by resources from the Lexington Veterans Affairs Medical Center. Dr. Dauerman has consulted for Novartis, Abbott Vascular, St. Jude, Medtronic, MDS Scientific, Gilead Pharmaceuticals, BMS/Sanofi Partnership, and The Medicines Company; and research grants from Abbott Vascular and Medtronic . Ms. French has consulted for Regado Biosciences. Dr. Becker has received grant support from AstraZeneca , BMS/Sanofi Partnership , Johnson & Johnson , Regado Biosciences , Schering Corporation , and The Medicines Company ; received honoraria from AstraZeneca and Daiichi/Eli Lilly; and consulted for Portola Pharmaceuticals, Regado Biosciences, and The Medicines Company. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Keywords

  • bleeding
  • inflammation
  • platelets
  • sex
  • thrombosis
  • women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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