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Sex, gender and venous thromboembolism

do we care enough?

Faioni, Elena M.a,b; Zighetti, Maddalena L.a; Vozzo, Nadia P.a

Blood Coagulation & Fibrinolysis: December 2018 - Volume 29 - Issue 8 - p 663–667
doi: 10.1097/MBC.0000000000000773

The role of sex and gender in determining clinical presentation, diagnostic approach and outcomes of venous thromboembolism is not fully and systematically addressed, except for hormone-related events in women. A lack of knowledge is also apparent regarding drug prescription patterns, physician bias, enrolment in clinical studies and analysis of sex-related confounders in preclinical and clinical studies. As was shown for cardiovascular disease, ignoring sex and gender in medicine can have important impact on outcomes, including mortality. In this review, we seek to address some aspects of venous thromboembolism such as epidemiology and clinical presentation, recurrence, risk factors, animal studies, safety and efficacy of antithrombotic drugs, highlighting what is known and what is not regarding the role of sex and gender, and hoping to focus some interest and to promote the inclusion of these variables in all future studies on venous thromboembolism.

aImmunohematology and Transfusion Medicine Service (SIMT), Ospedale San Paolo, ASST Santi Paolo e Carlo

bDepartment of Health Sciences (DiSS), Università degli Studi di Milano, Milan, Italy

Correspondence to Elena M. Faioni, MD, ASST-Santi Paolo e Carlo, Immunohematology and Transfusion Medicine Service (SIMT), SIMT Ospedale San Paolo, Via A. di Rudinì, 8, 20142 Milan, Italy. E-mail:

Received 17 August, 2018

Accepted 23 August, 2018

Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.