Grodecki K, et al. - Researchers assessed gender-related differences in post-discharge bleeding among subjects with acute coronary syndromes (ACS) on dual antiplatelet therapy. It was observed that bleeding events occurred more frequently in women. However, female sex itself was not an independent risk factor. The findings demonstrated that newer antiplatelet agents were an independent risk factor for bleeding only in women.

Methods

• For this investigation, 13,727 ACS patients who had percutaneous coronary intervention and were discharged on dual antiplatelet therapy (either with clopidogrel or prasugrel/ticagrelor) were examined.
• Researchers defined the endpoint as intracranial bleeding or any other bleeding leading to hospitalization and/or red blood transfusion.

Results

• The study results showed that vs males (3.7% vs 2.7%, log-rank P=0.001), post-discharge bleeding was reported more frequently in females.
• It was observed that females (n = 3,165, 23%) were older compared to men (69.0 vs 61.5 years, P < 0.001) and had more comorbidities.
• In multivariate analysis female sex was not identified as an independent risk factor of bleeding (HR 1.012, CI 0.805 to 1.274, P=0.816).
• Data revealed that administration of newer antiplatelet agents vs clopidogrel was correlated with an over twofold greater bleeding rate in females (7.3% vs 3.5%, log-rank P=0.004), but not in males (2.6% vs 2.7%, log-rank P=0.887).
• According to the findings, differences among females remained significant after propensity score matching (7.2% vs 2.4%, log-rank P=0.020) and multivariate analysis affirmed that newer antiplatelet agents were independent risk factor for bleeding only in women (HR 2.775, CI 1.613 to 4.774, P < 0.001).