Sixty years of research into ancestry differences in platelet function

Studies investigating the role of differential platelet function across various ancestry groups have been ongoing since at least the middle twentieth century. Consistently identified trends include differential frequency of CD36 deficiencies, variability in the efficacy of the antiplatelet functions of clopidogrel, increased PAR4 reactivity observed among African ancestry individuals, and reduced ristocetin-induced platelet aggregation also observed in African ancestry. Nonetheless, consensus is lacking in many areas. Replication in many of these studies is poor, utilized models may lack the necessary covariates to effectively capture environmental effects, and the represented cohorts disproportionately lean North American. Further comparative research of platelet phenotypes may yield important clinical insights and benefits; though to accomplish this a collaborative, international effort between institutes would be required. In this review, we discuss what is currently understood regarding differential platelet reactivity between ancestry groups, what areas are inadequately characterized, and the technical and organizational aspects which should be considered in future research.