Is There a Gender-Related Difference in the Cardioprotective Effects of Low-Dose Aspirin?
Although gender-based differences in salicylate metabolism have been reported,54 these do not appear to influence the pharmacodynamics of the antiplatelet effect of aspirin, which is substantially identical in men and women, both in terms of dose and time dependence.2,55 A gender-related difference in the production of 15-epi-lipoxin A4 has been reported in healthy subjects treated with low-dose aspirin (81 mg/d for 8 weeks).56 15-Epi-lipoxin A4 is synthesized via the transcellular metabolism of 15R-hydroxy-eicosatetraenoic acid (15R-HETE), which is produced by aspirin-acetylated COX-2.57 Aspirin-treated females showed a positive correlation between age and 15-epi-lipoxin A4 levels, whereas a negative correlation was observed in men. The clinical significance of this observation is presently unknown because of the lack of convincing evidence for a gender-based difference in the cardioprotective effect of aspirin in high-risk patients.2,3 At variance with the results of the first 5 prim