Racial Variability in Platelet Response Among Patients With Peripheral Artery Disease

Abstract

Introduction: Peripheral artery disease (PAD) is prevalent among the elderly population, with Black Americans facing a higher incidence and complications than White Americans. Antiplatelet therapy is crucial for PAD. This observational study aims to discern racial variability in platelet function using viscoelastic assays in patients' postrevascularization for PAD.

Methods: Patients with PAD who underwent revascularization between December 2020 and October 2023 were prospectively enrolled. The cohort was divided by race and antiplatelet therapy regimen. Serial perioperative Thromboelastography with Platelet Mapping assays were performed, and the platelet function was evaluated.

Results: A total of 42 patients met the study criteria, and 99 samples were analyzed. In the Thromboelastography with Platelet Mapping assay, the White-Americans cohort showed a significantly lower maximum amplitude (clot strength), lower percentage of platelet aggregation (platelet reactivity), and a significantly higher percentage of platelet inhibition than Black, Asian, and Hispanic Americans on the same antiplatelet regimen.

Conclusions: These findings suggest potential racial disparities in platelet response to standard medications, highlighting the critical need for personalized pharmacological approaches that account for genetic and physiological variations across different ethnic populations. Further research is essential to elucidate the underlying mechanisms of these differential platelet responses, which could have significant implications for precision medicine and targeted therapeutic strategies.

Keywords: Antiplatelet; Peripheral artery disease; Platelet mapping; Race; Revascularization; Thromboelastography; Thrombosis.