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Gender differences in blood thrombogenicity in hyperlipidemic patients and response to pravastatin.
Dangas, G; Smith, D A; Badimon, J J; Unger, A H; Shao, J H; Meraj, P; Cohen, A M; Levine, D; Fallon, J T; Ambrose, J A.
Afiliación
  • Dangas G; Cardiovascular Institute, Mount Sinai Medical Center, New York, New York, USA. gdd1@mhg.edu
Am J Cardiol ; 84(6): 639-43, 1999 Sep 15.
Article en En | MEDLINE | ID: mdl-10498131
Thrombotic risk in hyperlipidemic women and its response to lipid therapy is unknown. We prospectively studied 28 men and 29 women with high low-density lipoprotein (LDL) cholesterol during 6 months of therapy with pravastatin. Women had significantly higher high-density lipoprotein (HDL) cholesterol (54.2 +/- 1.7 vs 39.5 +/- 2.2 mg/dl, p <0.01), lower prevalence of coronary artery disease (41% vs 67%, p = 0.04), and otherwise similar baseline characteristics compared with men. Both genders achieved a 33% reduction in LDL at 6 weeks (188 +/- 6 to 133 +/- 5 mg/dl) and maintained similar LDL levels throughout the study. Systemic hemostatic markers and thrombus formation under dynamic flow conditions were evaluated at baseline, and at 3 and 6 months of follow-up. Prothrombin fragment F1.2, a marker of thrombin generation, was higher in women versus men at baseline (2.4 +/- 0.2 vs 1.4 +/- 0.3 nmol/L, p = 0.02). The levels decreased in women to 2.0 +/- 0.3 nmol/L at 3 months and to 1.6 +/- 0.2 nmol/L at 6 months (p <0.045, analysis of variance), whereas it remained unchanged in men. Plasminogen activator inhibitor-I significantly decreased at 3 and 6 months of follow-up: by 12.6% and 18.7%, respectively, in women, and by 18.8% and 23.5%, respectively, in men. Similarly, tissue plasminogen activator decreased significantly by 7.4% in women and 11.8% in men at 6 months compared with baseline. Fibrinogen showed an increase in both genders at follow-up. Thrombus formation was similar at baseline between the 2 genders, and decreased at 3 and 6 months compared with baseline by 12.5% and 29.5% in women, and by 18.6% and 19.4% in men (p <0.04 at 6 months vs baseline in both men and women). Other markers, including C-reactive protein, fibrinopeptide A, D-dimer, and factor VIIa, did not differ between genders and did not change with therapy. Thus, despite higher HDL, and lower incidence of coronary disease, women with high LDL had a comparable thrombotic and/or fibrinolytic profile to men and even evidence of increased thrombin generation at baseline. Blood thrombogenicity was reduced with pravastatin in both genders; in addition, thrombin generation was gradually reduced in women to a level similar to that of men by 6 months of follow-up.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pravastatina / Trombofilia / Hipercolesterolemia / LDL-Colesterol / Anticolesterolemiantes Tipo de estudio: Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Cardiol Año: 1999 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pravastatina / Trombofilia / Hipercolesterolemia / LDL-Colesterol / Anticolesterolemiantes Tipo de estudio: Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Cardiol Año: 1999 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos