{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:06:18Z","timestamp":1788487578360,"version":"build-2803163510"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","funder":[{"DOI":"10.13039\/100010447","name":"Deutsches Zentrum f\u00fcr Herz\u2013Kreislaufforschung","doi-asserted-by":"crossref","award":["FKZ 81X1600501"],"award-info":[{"award-number":["FKZ 81X1600501"]}],"id":[{"id":"10.13039\/100010447","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Data on sex-specific pharmacodynamic differences between prasugrel and ticagrelor in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) are limited.<\/jats:p>\n                  <jats:p>This study aims to evaluate sex-specific differences in platelet inhibition with prasugrel and ticagrelor in ACS patients undergoing PCI.<\/jats:p>\n                  <jats:p>This prespecified ISAR-REACT (Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment) 5 substudy included 598 P2Y12 inhibitor-naive patients (126 women, 472 men) undergoing PCI with one platelet function test within 24\u2009hours after loading with prasugrel or ticagrelor. The primary endpoint was adenosine diphosphate (ADP)-induced platelet aggregation (PA) \u226424\u2009hours post-loading. Ischemic events (death, myocardial infarction, or stroke) and major bleeding (Bleeding Academic Research Consortium [BARC] 3\u20135) were assessed at 12 months.<\/jats:p>\n                  <jats:p>Baseline ADP-induced PA was higher in women. After loading, women had lower PA than men (median 92 vs. 122 aggregation units [AU]\u2009\u00d7\u2009min; p\u2009=\u20090.006). Multivariable analysis showed that male sex and ticagrelor were independently associated with higher PA, with a significant sex-by-treatment interaction (p\u2009=\u20090.031). Women had significantly lower PA than men with prasugrel (77 vs. 118 AU\u2009\u00d7\u2009min; p\u2009=\u20090.001), but similar PA with ticagrelor (136 vs. 138 AU\u2009\u00d7\u2009min; p\u2009=\u20090.787). Twelve-month ischemic outcomes were similar between sexes in both groups. Major bleeding was higher in women than men receiving prasugrel (13.6% vs. 5.6%; Hazard Ratio (HR) 2.61; p\u2009=\u20090.023), but similar with ticagrelor.<\/jats:p>\n                  <jats:p>In patients with ACS undergoing PCI, women exhibited higher baseline platelet reactivity than men. After loading with the study drug, women showed stronger platelet inhibition than men with prasugrel, but not with ticagrelor. A significant interaction between sex and treatment effect on ADP-induced PA was observed.<\/jats:p>","DOI":"10.1055\/a-2888-9768","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T00:47:08Z","timestamp":1780706828000},"source":"Crossref","is-referenced-by-count":1,"title":["Sex-Dependent Platelet Inhibition with Prasugrel and Ticagrelor after Percutaneous Coronary Intervention in Acute Coronary Syndromes"],"prefix":"10.1055","author":[{"given":"Doruntina","family":"Lahu","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Bavaria, Germany","place":["Munich"],"department":["Klinik f\u00fcr Herz-und Kreislauferkrankungen"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorenzo","family":"Simonetti","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Bavaria, Germany","place":["Munich"],"department":["Klinik f\u00fcr Herz-und Kreislauferkrankungen"]},{"name":"University of Naples Federico II, Italy","place":["Naples"],"department":["Department of Advanced Biomedical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elda","family":"Koka","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Bavaria, Germany","place":["Munich"],"department":["Klinik f\u00fcr Herz-und Kreislauferkrankungen"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Mayer","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Bavaria, Germany","place":["Munich"],"department":["Klinik f\u00fcr Herz-und Kreislauferkrankungen"]},{"name":"Partner Site Munich Heart Alliance, Germany","department":["German Center for Cardiovascular Research (DZHK)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shqipdona","family":"Lahu","sequence":"additional","affiliation":[{"name":"Partner Site Munich Heart Alliance, Germany","department":["German Center for Cardiovascular Research (DZHK)"]},{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin I Kardiologie, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Germany","place":["Munich"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Sch\u00fcpke","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Bavaria, Germany","place":["Munich"],"department":["Klinik f\u00fcr Herz-und Kreislauferkrankungen"]},{"name":"Partner Site Munich Heart Alliance, Germany","department":["German Center for Cardiovascular Research (DZHK)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Janisch","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Bavaria, Germany","place":["Munich"],"department":["Klinik f\u00fcr Herz-und Kreislauferkrankungen"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Ludwig","family":"Laugwitz","sequence":"additional","affiliation":[{"name":"Partner Site Munich Heart Alliance, Germany","department":["German Center for Cardiovascular Research (DZHK)"]},{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin I Kardiologie, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Germany","place":["Munich"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heribert","family":"Schunkert","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Bavaria, Germany","place":["Munich"],"department":["Klinik f\u00fcr Herz-und Kreislauferkrankungen"]},{"name":"Partner Site Munich Heart Alliance, Germany","department":["German Center for Cardiovascular Research (DZHK)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4341-891X","authenticated-orcid":false,"given":"Adnan","family":"Kastrati","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Bavaria, Germany","place":["Munich"],"department":["Klinik f\u00fcr Herz-und Kreislauferkrankungen"]},{"name":"Partner Site Munich Heart Alliance, Germany","department":["German Center for Cardiovascular Research (DZHK)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabell","family":"Bernlochner","sequence":"additional","affiliation":[{"name":"Partner Site Munich Heart Alliance, Germany","department":["German Center for Cardiovascular Research (DZHK)"]},{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin I Kardiologie, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, Germany","place":["Munich"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"issue":"38","key":"ref1","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC Guidelines for the management of acute coronary syndromes","volume":"44","author":"R A Byrne","year":"2023","journal-title":"Eur Heart J"},{"issue":"14","key":"ref2","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1093\/eurheartj\/ehaa575","article-title":"2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation","volume":"42","author":"J P Collet","year":"2021","journal-title":"Eur Heart 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