Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis

Thrombotic and bleeding risks differ between sexes, partly in relation to distinct biology and hormonal status, but also due to differences in age, comorbidities, and body size at presentation. Women experience frequent fluctuations of prothrombotic and bleeding status related to menstrual cycle, us...

ver descrição completa

Detalhes bibliográficos
Autores: Paradies, V, Masiero, G, Rubboli, A, Van Beusekom, HMM, Costa, F, Capranzano, P, Degrauwe, S, Gorog, DA, Jorge, CM, Buchanan, GL, Alasnag, M, Trabattoni, D, Fraccaro, C, Sibbing, D, Dudek, D, Vilahur, G, Chieffo, A, Mehran, R, Capodanno, D, Barbato, E, Siller-Matula, JM
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p19950
Acesso em linha:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19950
Access Level:acceso abierto
Palavra-chave:antithrombotic therapies
bleeding
coagulation
gender
haemostasis
platelets
sex
thrombosis
id ES_ebddcf3c4248e132eaa06bf3a04a70e1
oai_identifier_str oai:iibsantpau.fundanetsuite.com:p19950
network_acronym_str ES
network_name_str España
repository_id_str
spelling Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on ThrombosisParadies, VMasiero, GRubboli, AVan Beusekom, HMMCosta, FCapranzano, PDegrauwe, SGorog, DAJorge, CMBuchanan, GLAlasnag, MTrabattoni, DFraccaro, CSibbing, DDudek, DVilahur, GChieffo, AMehran, RCapodanno, DBarbato, ESiller-Matula, JMantithrombotic therapiesbleedingcoagulationgenderhaemostasisplateletssexthrombosisThrombotic and bleeding risks differ between sexes, partly in relation to distinct biology and hormonal status, but also due to differences in age, comorbidities, and body size at presentation. Women experience frequent fluctuations of prothrombotic and bleeding status related to menstrual cycle, use of oral contraceptives, hormone replacement therapy, or menopause. Although clinical studies tend to underrepresent women, available data consistently support sex-specific differences in the baseline thrombotic and haemorrhagic risks. Compared with men, women feature an increased risk of in-hospital bleeding related to invasive procedures, as well as long-term out-of-hospital bleeding events. In addition, the inappropriate dosing of antithrombotic drugs, which is not adapted to body weight or renal function, is more frequently associated with an increased risk of bleeding in women compared to men. While acute coronary syndrome (ACS) studies support similar antithrombotic drug efficacy, irrespective of sex, women may receive delayed treatment due to bias in their referral, diagnosis, and invasive treatment decisions. The current clinical consensus statement highlights the need for an increased awareness of sex-specific risks and biases in ACS management, with a focus on sex-specific bleeding mitigation strategies, antithrombotic management in special conditions (e.g., myocardial infarction with non-obstructive coronary arteries), and barriers to female representation in cardiovascular trials. This manuscript aims to provide expert opinion, based on the best available evidence, and consensus statements on optimising antithrombotic therapy according to sex, which is critical to improve sex-based disparities in outcome.EUROPA EDITION2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19950EuroInterventionISSN: 1774024XISSNe: 19696213reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p199502026-06-14T12:41:47Z
dc.title.none.fl_str_mv Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis
title Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis
spellingShingle Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis
Paradies, V
antithrombotic therapies
bleeding
coagulation
gender
haemostasis
platelets
sex
thrombosis
title_short Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis
title_full Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis
title_fullStr Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis
title_full_unstemmed Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis
title_sort Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis
dc.creator.none.fl_str_mv Paradies, V
Masiero, G
Rubboli, A
Van Beusekom, HMM
Costa, F
Capranzano, P
Degrauwe, S
Gorog, DA
Jorge, CM
Buchanan, GL
Alasnag, M
Trabattoni, D
Fraccaro, C
Sibbing, D
Dudek, D
Vilahur, G
Chieffo, A
Mehran, R
Capodanno, D
Barbato, E
Siller-Matula, JM
author Paradies, V
author_facet Paradies, V
Masiero, G
Rubboli, A
Van Beusekom, HMM
Costa, F
Capranzano, P
Degrauwe, S
Gorog, DA
Jorge, CM
Buchanan, GL
Alasnag, M
Trabattoni, D
Fraccaro, C
Sibbing, D
Dudek, D
Vilahur, G
Chieffo, A
Mehran, R
Capodanno, D
Barbato, E
Siller-Matula, JM
author_role author
author2 Masiero, G
Rubboli, A
Van Beusekom, HMM
Costa, F
Capranzano, P
Degrauwe, S
Gorog, DA
Jorge, CM
Buchanan, GL
Alasnag, M
Trabattoni, D
Fraccaro, C
Sibbing, D
Dudek, D
Vilahur, G
Chieffo, A
Mehran, R
Capodanno, D
Barbato, E
Siller-Matula, JM
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv antithrombotic therapies
bleeding
coagulation
gender
haemostasis
platelets
sex
thrombosis
topic antithrombotic therapies
bleeding
coagulation
gender
haemostasis
platelets
sex
thrombosis
description Thrombotic and bleeding risks differ between sexes, partly in relation to distinct biology and hormonal status, but also due to differences in age, comorbidities, and body size at presentation. Women experience frequent fluctuations of prothrombotic and bleeding status related to menstrual cycle, use of oral contraceptives, hormone replacement therapy, or menopause. Although clinical studies tend to underrepresent women, available data consistently support sex-specific differences in the baseline thrombotic and haemorrhagic risks. Compared with men, women feature an increased risk of in-hospital bleeding related to invasive procedures, as well as long-term out-of-hospital bleeding events. In addition, the inappropriate dosing of antithrombotic drugs, which is not adapted to body weight or renal function, is more frequently associated with an increased risk of bleeding in women compared to men. While acute coronary syndrome (ACS) studies support similar antithrombotic drug efficacy, irrespective of sex, women may receive delayed treatment due to bias in their referral, diagnosis, and invasive treatment decisions. The current clinical consensus statement highlights the need for an increased awareness of sex-specific risks and biases in ACS management, with a focus on sex-specific bleeding mitigation strategies, antithrombotic management in special conditions (e.g., myocardial infarction with non-obstructive coronary arteries), and barriers to female representation in cardiovascular trials. This manuscript aims to provide expert opinion, based on the best available evidence, and consensus statements on optimising antithrombotic therapy according to sex, which is critical to improve sex-based disparities in outcome.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19950
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19950
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv EUROPA EDITION
publisher.none.fl_str_mv EUROPA EDITION
dc.source.none.fl_str_mv EuroIntervention
ISSN: 1774024X
ISSNe: 19696213
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869423265213054976
score 15.81155

Registos relacionados