en focusing particularly on every time point applying bootstrapping, female sex was non-significantly related with higher levels of ticagrelor concentration at 1-hour just after randomization [corresponding to measurements performed pre-PCI (T1); median difference 57 ng/mL (IQR -6195)], at one hundred minutes soon after randomization [corresponding to measurements performed quickly after principal PCI (T2); median distinction 97 ng/mL (IQR -1722)], at three hours after randomization [corresponding to measurements performed 1 hour after major PCI (T3); median distinction 102 ng/mL (IQR -3737)], and at 8 hours following randomization [corresponding to measurements performed about 6 hours right after PCI (T4); median distinction 132 (IQR -6191)].Frontiers in Cardiovascular Medicine | frontiersin.orgOctober 2021 | Volume eight | ArticleTavenier et al.Sex Differences in platelet ReactivityClinical EndpointsWithin 30 days after STEMI three re-infarctions and two BARC three bleedings occurred in females. In males a single acute stent thrombosis was seen. When taking into account all bleeding events, females had in addition 7 (12.1 ) BARC 1 bleeding Bim Formulation events and males had 11 (eight ) BARC 1 and 6 (4.four ) BARC 2 bleedings events. Bleeding events have been slightly more frequent in females (overall difference in bleeding events 15.5 vs. 12.four , P = 0.048).DISCUSSIONThis sub-analysis with the ON-TIME three trial showed that powerful platelet inhibition with crushed ticagrelor was reached at many time points prior and immediately after primary PCI in both female and male patients with STEMI. However, ticagrelor plasma concentrations had been larger in females compared with males at many timepoints. Literature shows greater platelet reactivity in healthier females, compared to males, who had been not treated with antiplatelet therapy (three, 4). Furthermore, higher platelet reactivity was measured in female sufferers, who underwent elective PCI and were treated with aspirin and clopidogrel in comparison with their male counterparts (five). Nevertheless, in yet another study amongst patients treated with dual antiplatelet therapy, no impact of sex was seen on platelet reactivity or high-on therapy platelet reactivity, a phenomenon linked with main cardiovascular events (15), at 300 days just after an acute coronary syndrome (ACS) or elective PCI (6). Furthermore, sex was not a substantial predictor of high-on platelet reactivity in post-ACS patients treated with aspirin and prasugrel for 1 months soon after discharge (7). Also, a sub-analysis from the ADAPT-DES study showed that the association of HPR and stent thrombosis at 1 year was comparable in females and males (eight). Abovementioned studies on platelet reactivity have been performed inside the sub-acute or chronic phase following initiation of dual antiplatelet therapy for ACS or elective PCI and showed inconclusive outcomes. Importantly, our analysis focused on sex variations in P2Y12 platelet inhibition in the acute phase of STEMI and didn’t show any considerable variations. In this sub-analysis ticagrelor absorption was greater in females compared with males at various timepoints, which could potentially have resulted in slightly extra observed all round bleedings in females. CDK1 site Suggested explanations might consist of accompanied differences in body fat distribution and physique mass index (BMI) between females and males. Though, within this analysis BMI did not considerably modify the association of sex and ticagrelor concentration. Also, current use of P2Y12 inhibitors was an exclusion criterion and, consequently, cannot clarify the diff