Abstract
Despite knowing that females are at a higher risk of major adverse cardiac events (MACE) and poor prognosis after percutaneous transluminal coronary angioplasty (PTCA), there are very few studies focusing on urinary 11-dehyrdo-thromboxane B2 (dh-TxB2) concentration (for aspirin non-responsiveness) differences among males and females. The present prospective observational study aimed to evaluate the dh-TxB2 levels and associate them with clinical outcomes in males and females with acute coronary syndrome (ACS) after PTCA. The dh-TxB2 ELISA assay was carried out twice, at baseline and 6 months follow-up, and outcomes were assessed for 1 year. The average cut-off value of dh-TxB2 was ≥1,496 pg/mg creatinine by the receiver operating characteristic curve estimation. A total of 192 patients (140 men and 52 women) were enrolled. At baseline, 17 (12.1%) males and 7 (13.5%) females had high dh-TxB2 levels, whereas at 6 months, 22 (15.9%) males and 4 (7.8%) females showed high dh-TxB2 levels. The concentration of dh-TxB2 was higher in females than males at baseline. Composite MACE was not different between genders significantly even when the dh-TxB2 levels were high. Women experienced higher MACE incidences than men (13.5% vs. 9.3%).
Highlights
Despite knowing that females are at a higher risk of major adverse cardiac events (MACE) and poor prognosis after percutaneous transluminal coronary angioplasty (PTCA), there are very few studies focusing on urinary 11-dehyrdothromboxane B2 concentration differences among males and females
The aim of the present study is to investigate the gender-specific dehyrdo-thromboxane B2 (dhTxB2) level and its association with MACE after PTCA in acute coronary syndrome (ACS) patients
Dual antiplatelet medication utilization rate was consistent with current clinical practice guidelines, and no difference was observed between genders (Table 1)
Summary
Acute coronary syndrome (ACS) is caused by coronary atherosclerosis rupture, platelet activation, aggregation, and thrombosis and is significantly associated with morbidity and mortality. Antiplatelet therapy, especially aspirin, is the most important part of pharmacotherapy to lessen the risk of future cardiovascular (CV) events (Badimon et al, 2012; Smith et al, 2015). It acts through acetylating platelet cyclooxygenase-1 (COX-1) irreversibly, inhibiting the formation of thromboxane A2 (TxA2). The end metabolite 11-dehyrdo-thromboxane B2 (dhTxB2) is a stable biomarker of systemic TxA2 biosynthesis and Multiple studies have pointed out the gender differences in pathophysiological and clinical expressions of atherosclerosis. The female gender has been associated with poorer prognosis after coronary revascularization and has a high risk of death and MI (Josiah and Farshid, 2019; Guo et al, 2018). Some studies suggest that the female gender itself is an independent risk factor for the outcomes of CV and have persistent gender differences in Chauhan et al / Journal of Applied Pharmaceutical Science 10 (11); 2020: 010-017 outcomes after angioplasty, while other studies have demonstrated equal probabilities of occurrence of events in male and females (Kurlansky et al, 2017; Pendyala et al, 2013; Rao et al, 2019)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
