Ischemic heart diseases (IHD) are not synonymous with obstructive flow-limiting coronary artery disease (CAD), especially in women presenting with symptoms of myocardial ischemia. No obstructive CAD is considered a plausible reason for worse outcomes in women because it cannot benefit from invasive coronary percutaneous interventions and there is a lack of standard medication approach. Platelets may play a crucial role in the pathogenesis of ischemia in no obstructive CAD as they release several vasoconstrictor molecules, which could account for the microvascular coronary dysfunction behind the ischemia in this specific category of IHD patients. However, scarce data on sex differences of platelet biomarkers are available. Our hypothesis is that compared to men, women with no obstructive CAD exhibit a hyperactivation of platelet function that ultimately sustains the ischemic phenomenon in patients with no obstructive CAD. Therefore, our objectives will be: (i) to analyze sex differences in biomarkers of platelet function in patients with IHD and no obstructive coronary artery disease (Objective 1) ; ii) to assess the association between platelet biomarkers and both short- and long-term clinical outcomes according to sex (Objective 2). We will analyze IHD patients, not on chronic antiplatelet therapy, with available baseline blood samples, clinical and angiographic data. Soluble P selectin (sPs), soluble CD40L (sCD40L), thromboxane B2 (TxB2) will be measured. A sex-stratified biomarkers analysis according to clinical presentation (i.e. acute vs chronic) will be performed. No obstructive disease will be defined for coronary stenosis
Sex as a biological variable (SABV) is a key part of the innovative approach to life science research. International Societies such as National Institutes of Health (NIH), Canadian Institute of Health and Research and the Europen Commision promote the integration of sex and gender in research to enhance reproducibility through rigor and transparency. The SABV policy requires researchers to factor sex into
the design, analysis, and reporting of vertebrate animal and human studies.
If researchers assume that people are more alike than they are different, important differences between sexes, races, and exposures will be overlooked. In fact, sex was a variable that was often considered to be negligible and, hence, one that often could be ignored.
Therefore, In our proposal, we decided to approach a relevant clinical issue under the lens of sex and gender approach to identify the new potential targets for a more high-quality treatment for both women and men.