A Study of Role of Gender in High on Treatment Platelet Reactivity (HRPR) on outcome in Patients Undergoing Percutaneous Coronary Intervention

Background: Platelet inhibition is necessary in post PCI period as it is one of the risk factor for stent thrombosis and there are only few studies on platelet aggregation and inhibition for gender comparison between males and females. Methods: We have studied 142 consecutive in patients from NIMS cardiology department from august 2014 to 2016 who underwent PTCA , in the follow up period of 15th day we did platelet aggregation test for all the patients . We calculated platelet inhibition by 100 – platelet aggregation. Results: Out of 142 patients 30 are females 112 are males. Both the groups are matched in baseline characteristic of mean age 57 years, hypertension, diabetes, type of presentation ( stable or unstable) weight, eGFR, type of stent, presence or absence of LV dysfunction, single or multi vessel disease. There is significant difference in smoking (p= 0.000) between males and females, and hemoglobin levels (12.12 v/s 13.60 g/dl, p = 0.04) but there is tendency for higher platelet aggregation (i.e. lesser platelet inhibition) in females, Chi square test person uncorrected chi square = 1.238, p=0.266, (fisher exact test 2 tailed p value 0.545) (Odds ratio (OR) = 0.00, 95% ci 0.00 to 6.649 Relative Risk (RR) = 0.00, 95% CI 0.00 TO 5.389). There are 9 (30%) females with higher end on platelet activity >50% in whom there are nil events in them and there are 24 (21.43%) males with higher end platelet activity >50% in whom there are 3 non cardiac events ( AV fistula, CSA+CIN, CCF)in them but total event rate is higher in females(10%) than in males (8.04%). When estimate of difference is calculated with 95% CI is (-0.125) with test for difference 0 and p value of 0.064 Conclusion: Though there is a tendency of lesser platelet inhibition in female's events rates are higher compared to males (10% v/s 8.04%) with p = 0.064 which again shows tendency but not significance.