Pharmacovigilance Center of Bordeaux, Department of Medical Pharmacology, University Hospital of Bordeaux, Bordeaux, France.
Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France.
Pharmacotherapy. 2022 Jul;42(7):585-589. doi: 10.1002/phar.2706. Epub 2022 Jun 8.
Monoclonal antibodies acting on the calcitonin gene-related peptide or its receptor (CGRP-mabs) are novel drugs for resistant migraine prophylaxis. As CGRP-mabs cause inhibition of vasodilatation, their use is reserved to patients with no recent history of cardiovascular diseases. We report a case of myocardial infarction associated with erenumab.
A 57-year-old woman with a familial history of coronaropathy was first treated with erenumab 70 mg for 6 months and then increased to 140 mg. Almost 5 months after, the patient presented chest pain, increased troponin, and abnormal electrocardiogram. A myocardial infarction without coronarography abnormality was diagnosed through MRI.
Further evidence is needed to assess the risk of myocardial infarction in patients treated with a CGRP-mab. In patients over 40 years of age, the risk of coronary or cardiovascular events should be assessed using risk tables or algorithms to take into account cardiovascular risk factors. This may be complemented by appropriate examinations to measure the burden of coronary atherosclerosis, if necessary.
作用于降钙素基因相关肽或其受体（CGRP-mab）的单克隆抗体是治疗耐药性偏头痛的新型药物。由于 CGRP-mab 可抑制血管扩张，因此将其保留用于无近期心血管疾病史的患者。我们报告了一例与依那西普相关的心肌梗死病例。
一名 57 岁女性，有家族性冠心病病史，首先接受依那西普 70mg 治疗 6 个月，然后增加至 140mg。近 5 个月后，患者出现胸痛、肌钙蛋白升高和心电图异常。通过 MRI 诊断为无冠状动脉造影异常的心肌梗死。
需要进一步的证据来评估接受 CGRP-mab 治疗的患者发生心肌梗死的风险。对于 40 岁以上的患者，应使用风险表或算法评估冠状动脉或心血管事件的风险，以考虑心血管危险因素。如有必要，还可以通过适当的检查来测量冠状动脉粥样硬化的负担。
