REVIEW

Acute coronary syndromes: should women receive less antithrombotic medication than men?

N Danchin

Correspondence to:
Correspondence to:
Professeur N Danchin
Cardiologie, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France; nicolas.danchin{at}egp.ap-hop-paris.fr

A recent meta-analysis of all randomised trials assessing the efficacy and safety of glycoprotein IIb/IIIa agents with acute coronary syndromes showed that there was a significant interaction with sex. Explaining this difference requires an analysis of whether it has any pathophysiological basis, whether antithrombotic medications are indeed less efficacious in women in different clinical situations, and whether there are any specific reasons that may have led to the provocative results of the meta-analysis.

Keywords: sex; acute coronary syndromes; glycoprotein IIb/IIIa inhibitors; antithrombotic medications

Abbreviations: CREDO, clopidogrel for the reduction of events during observation; CURE, clopidogrel in unstable angina to prevent recurrent events; EPIC, evaluation of c7E3 Fab in the prevention of ischemic complications; EPILOG, evaluation of PTCA to improve long-term outcome with abciximab GP IIb/IIIa blockade; EPISTENT, evaluation of platelet IIb/IIIa inhibitor for stenting; ESPRIT, enhanced suppression of the platelet GP IIb/IIIa receptor with Integrilin therapy; FRISC II, Fragmin and fast revascularization during instability in coronary artery disease; GUSTO, global utilization of streptokinase and t-PA for occluded coronary arteries I; GUSTO IV ACS, global utilization of strategies to open occluded arteries IV, acute coronary syndromes; HOPE, heart outcomes prevention evaluation; PARAGON, platelet IIb/IIIa antagonism for the reduction of acute coronary syndrome events in a global organization network; PRISM, platelet receptor inhibition for ischemic syndrome management; PRISM-PLUS, platelet receptor inhibition in ischemic syndrome management in patients limited by unstable signs and symptoms; PURSUIT, platelet glycoprotein IIb/IIIa in unstable angina: receptor suppression using Integrilin therapy; TIMI, thrombolysis in myocardial infarction; WISE, women’s ischemia syndrome evaluation

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Mega, J. L., Morrow, D. A., Ostor, E., Dorobantu, M., Qin, J., Antman, E. M., Braunwald, E. (2007). Outcomes and Optimal Antithrombotic Therapy in Women Undergoing Fibrinolysis for ST-Elevation Myocardial Infarction. Circulation 115: 2822-2828 [Abstract] [Full Text]