Background: Recent studies, such as PLATINUM Diversity, have shown that African American (AA) women have a higher risk of myocardial infarction after percutaneous coronary intervention (PCI); this risk may be increased by concomitant diabetes (DM). Disparities in post-PCI outcomes may be explained by differences in thrombogenicity among race and gender and DM.

Aims: To investigate the influence of race and gender on thrombogenicty in AA and Caucasians(C).

Methods: We included AA and Caucasian (C) men (M) and women (W) with and without DM undergoing elective coronary angiography (n=1,031).The viscoelastic properties of platelet-fibrin clot were measured pre-procedure using the TEG 5000 Hemostasis System.Thrombotic risk was defined as thrombin induced platelet-fibrin clot strength (TIP-FCS) >68mm.

Results: Baseline clinical characteristics were similar across the eight groups, however AA-W were more likely to have BMI > 35. There was greater TIP-FCS (P< 0.001 by
ANOVA) in AA vs C, W vs M and, DM vs non DM, respectively. AA-W with DM had the greatest thrombogenicity compared to all other groups (Figure). Multivariate
analysis showed that race and gender, DM, morbid obesity, and WBC count were independent predictors of thrombotic risk.

Conclusions: Thrombogenicity is a novel measurable cardiovascular risk factor that varies by race, gender and DM and is greatest in AA women with DM. These findings provide a plausible biologic mechanism for the gender-, race- and diabetes- related variances observed in the post PCI risk of ischemic events.

[Thrombotic Risk Prevalence]

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/african-american-women-with-diabetes-undergoing-catheterization-represent-most-prothrombotic-subgroup-an-explanation-for-the-platinum-diversity-study-results/