Sex-stratified differences in early antithrombotic treatment response in patients presenting with ST-segment elevation myocardial infarction
Primary result · HPRResult — go to the resultOdds ratio 4.58 95% CI 2.52–8.32Authors' conclusion
In this contemporary STEMI cohort, female STEMI patients remain at risk of bleeding complications after primary PCI. However, this is not explained by sex-specific differences in the pharmacodynamic response to pre-hospital DAPT initiation.
Study context
- Population
- STEMI patients receiving pre-hospital loading dose of crushed or integral prasugrel in the ambulance147 (23%) female
- Participants
- 633 patients
- Comparison
- Females vs males
- Femalesn = 147
- Primary endpoint
- Platelet reactivity levels and HPR (platelet reactivity ≥208) after DAPT initiation
- Follow-up
- 4 prespecified time points after DAPT initiation
Methodological detailssex-stratified substudy, 4 prespecified time points
- Sex-stratified substudy
- 4 prespecified time points
Primary result
HPR · baseline
Odds ratio
4.58
95% CI 2.52–8.32
P < 0.01
By group
Females
232
IQR 209–256
Males
195
IQR 171–220
Femalesvs Males
OR 4.58 (95% CI 2.52–8.32); P < 0.01
As reported in the abstract
- Female sex sole independent predictor of high platelet reactivity (HPR) at baseline (OR 5.67, 95% CI 2.56-12.53)
- P < 0.01
Safety
| Outcome | Females | Males | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Post-PCI bleeding | 10% | 2% | 6.02 (2.61–11.87) | P < 0.01 | |
| 0.050.21520Odds ratio (log scale) |
- Post-PCI bleeding — Female sex independent predictor of post-PCI bleeding (OR 3.25, 95% CI 1.09-9.72)
- P = .04
Original publication
Sex-stratified differences in early antithrombotic treatment response in patients presenting with ST-segment elevation myocardial infarction. Am Heart J. Published 31 December 2022. doi:10.
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