A Case of Atrioventricular Block Potentially Associated with Right Coronary Artery Lesion and Ticagrelor Therapy Mediated by the Increasing Adenosine Plasma Concentration
Joint Authors
Source
Case Reports in Vascular Medicine
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-04-19
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
Purpose.
To report a case of atrioventricular block (AVB) which might be associated with the right coronary artery lesion and the novel oral antithrombotic drug ticagrelor mediated by the increasing adenosine plasma concentration (APC).
Case Report.
A 65-year-old man was given loading dose of ticagrelor (180 mg) before coronary angiography with total thrombotic occlusion of right coronary artery and one stent was implanted.
On second day after successful percutaneous coronary intervention, ECG monitoring showed second-degree (Mobitz type I) AVB with prolonged PR interval (299 ms).
Hypothesis was drawn that elevated APC levels caused by ticagrelor would be the reason for AVB after excluding combination drugs or underlying disease.
APC might be an indicator of this side effect caused by the P2Y12 receptor inhibitors.
On fourth day after shifting to clopidogrel, the ECG showed normal sinus rhythm and PR interval depressed to 190 ms and APC dropped from 1.62 umol/L to 0.92 umol/L.
The bradycardia and AVB did not occur in the three-month follow-up.
Conclusion.
It was important to take the ticagrelor induced bradycardia into account particularly with the myocardial infarction of right coronary artery, treated with atrioventricular block drugs after initiating ticagrelor.
Also, we should shift ticagrelor to clopidogrel if AVB occurred.
American Psychological Association (APA)
Li, Xiaoye& Xue, Ying& Wu, Hongyi. 2018. A Case of Atrioventricular Block Potentially Associated with Right Coronary Artery Lesion and Ticagrelor Therapy Mediated by the Increasing Adenosine Plasma Concentration. Case Reports in Vascular Medicine،Vol. 2018, no. 2018, pp.1-3.
https://search.emarefa.net/detail/BIM-1151641
Modern Language Association (MLA)
Li, Xiaoye…[et al.]. A Case of Atrioventricular Block Potentially Associated with Right Coronary Artery Lesion and Ticagrelor Therapy Mediated by the Increasing Adenosine Plasma Concentration. Case Reports in Vascular Medicine No. 2018 (2018), pp.1-3.
https://search.emarefa.net/detail/BIM-1151641
American Medical Association (AMA)
Li, Xiaoye& Xue, Ying& Wu, Hongyi. A Case of Atrioventricular Block Potentially Associated with Right Coronary Artery Lesion and Ticagrelor Therapy Mediated by the Increasing Adenosine Plasma Concentration. Case Reports in Vascular Medicine. 2018. Vol. 2018, no. 2018, pp.1-3.
https://search.emarefa.net/detail/BIM-1151641
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1151641