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Peri- and Post-procedural Antithrombotic Therapy in Women

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Percutaneous Treatment of Cardiovascular Diseases in Women

Abstract

The proportion of women enrolled in clinical trials of antithrombotic therapy usually ranges from 20 to 30 %. Thus, these trials lack power to derive any definitive conclusions in women. Moreover, subgroup analyses of clinical trials according to gender are still not routinely reported, and clinical trials enrolling women only present a rarity. Women undergoing PCI differ from men in several ways, including an older age at disease presentation, a more adverse cardiovascular risk profile, and comorbidities. Despite these differences, there is no convincing evidence of gender-specific efficacy and safety of antithrombotic therapy. Due to their higher baseline risk, women tend to derive a higher absolute benefit from aggressive therapy. A consistent finding across many studies has been an increased bleeding risk in women. Due to the morbidity and mortality associated with bleeding, bleeding avoidance strategies derive special attention in women. Overdosing in women has been suggested to account for 25 % of their excessive bleeding risk. In summary, the still existing undertreatment of women with evidence-based antithrombotic therapy is not justified by current evidence. There is a great need to more thoroughly investigate the value of antithrombotic regimen in women.

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  1. Deutsches Herzzentrum München, Lazarettstr. 36, Munich, 80636, Germany

    Stefanie Schulz-Schüpke

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  1. Stefanie Schulz-Schüpke
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  1. Interventional Cardiology, Humanitas Research Hospital, Rozzano , Milano, Italy

    Patrizia Presbitero

  2. Interventional Cardiology, Klinik der Universität München Interventional Cardiology, München, Bayern, Germany

    Julinda Mehilli

  3. Hemodynamic Laboratory, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy

    Anna Sonia Petronio

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Schulz-Schüpke, S. (2017). Peri- and Post-procedural Antithrombotic Therapy in Women. In: Presbitero, P., Mehilli, J., Petronio, A. (eds) Percutaneous Treatment of Cardiovascular Diseases in Women. Springer, Cham. https://doi.org/10.1007/978-3-319-39611-8_6

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