Background: The biological differences among male and female, based on distinctive
expression of sex chromosomes, on varied gene-expression and on peculiar sexual
hormones, lead to important differences in physiology and pathophysiology.
Objective: The aim of this work was to briefly review the relationships among genderrelated
differences and clinical implications in antithrombotic therapy, that could be related
to sex-differences in platelet biology and coagulation reactions.
Results: The major clinical setting in which antithrombotic drugs are involved for the treatment
are atrial fibrillation, venous thromboembolisn, coronary artery disease and peripheral
artery diseases. Considering that a consistent body of evidences suggests that, on one hand,
human platelet activity may be influenced by sex and sex hormones and, on the other hand,
estrogens are likely to play a crucial role on the transcriptional regulation of coagulation
protein genes, the real impact of gender-related differences is still unclear. Moreover,
women and men present different responses to antithrombotic drugs, reflecting genderspecific
variances in pharmacokinetic profile, along with the physiological characteristics of
each gender. Thus, the efficacy and adverse effects of antithrombotic drugs may vary according
Conclusion: Several gender-related differences could be reported in haemostasis and
thrombosis pathophysiological mechanisms. Moreover, several data documented relevant
gender differences in antithrombotic management and clinical effectiveness. Further studies
are still needed to completely elucidate these issues.