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一例替格瑞洛诱发的窦性停搏病例。

A Case of Ticagrelor-Induced Sinus Pause.

作者信息

Pavlatos Nicholas T, Shah Aangi, Khan Muhammad, Jaiswal Vikash, Mattumpuram Jishanth

机构信息

Department of Internal Medicine, University of Louisville Hospital, Louisville, USA.

Department of Cardiology, University of Louisville Hospital, Louisville, USA.

出版信息

Cureus. 2023 Jul 13;15(7):e41821. doi: 10.7759/cureus.41821. eCollection 2023 Jul.

DOI:10.7759/cureus.41821
PMID:37575834
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10423005/
Abstract

Ticagrelor is an oral antiplatelet agent commonly used following percutaneous coronary intervention (PCI). There have been many reports describing bradyarrhythmias in the setting of ticagrelor use, most notably sinus pauses. This process is thought to be related to ticagrelor's inhibition of human equilibrative nucleoside transporter (hENT1), which reduces cellular uptake of adenosine. We present a case of a 58-year-old male who experienced prolonged sinus pauses 38 hours after starting ticagrelor following ST-elevation myocardial infarction with subsequent PCI and stent placement.

摘要

替格瑞洛是一种常用于经皮冠状动脉介入治疗(PCI)后的口服抗血小板药物。有许多报告描述了使用替格瑞洛时出现的缓慢性心律失常,最显著的是窦性停搏。这个过程被认为与替格瑞洛抑制人平衡核苷转运体(hENT1)有关,hENT1的抑制会减少细胞对腺苷的摄取。我们报告一例58岁男性患者,在ST段抬高型心肌梗死后接受PCI及支架置入术并开始使用替格瑞洛38小时后出现了长时间的窦性停搏。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6406/10423005/255386a454f0/cureus-0015-00000041821-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6406/10423005/97750dadd81f/cureus-0015-00000041821-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6406/10423005/66616266dde5/cureus-0015-00000041821-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6406/10423005/c07dab39f90c/cureus-0015-00000041821-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6406/10423005/255386a454f0/cureus-0015-00000041821-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6406/10423005/97750dadd81f/cureus-0015-00000041821-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6406/10423005/66616266dde5/cureus-0015-00000041821-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6406/10423005/c07dab39f90c/cureus-0015-00000041821-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6406/10423005/255386a454f0/cureus-0015-00000041821-i04.jpg

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本文引用的文献

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Heroin and its metabolites: relevance to heroin use disorder.海洛因及其代谢物:与海洛因使用障碍的相关性。
Transl Psychiatry. 2023 Apr 8;13(1):120. doi: 10.1038/s41398-023-02406-5.
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Prolonged sinus arrest due to the obstruction of a sinus node branch after percutaneous coronary intervention of the right coronary artery.右冠状动脉经皮冠状动脉介入治疗后因窦房结分支阻塞导致的长时间窦性停搏。
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Sinus Arrest Associated With Ticagrelor Therapy: A Case Report and Review of Literature.
替格瑞洛治疗相关的窦性停搏:一例病例报告及文献复习
Am J Ther. 2022;29(5):e585-e588. doi: 10.1097/MJT.0000000000001385. Epub 2021 May 11.
4
Sinus Node Dysfunction due to Occlusion of the Sinus Node Artery during Percutaneous Coronary Intervention.经皮冠状动脉介入治疗中窦房结动脉闭塞导致窦房结功能障碍。
J Interv Cardiol. 2021 Mar 30;2021:8810484. doi: 10.1155/2021/8810484. eCollection 2021.
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Adenosine and the Cardiovascular System: The Good and the Bad.腺苷与心血管系统:利弊并存
J Clin Med. 2020 May 6;9(5):1366. doi: 10.3390/jcm9051366.
6
Sinoatrial Arrest Caused by Ticagrelor after Angioplasty in a 62-Year-Old Woman with Acute Coronary Syndrome.替格瑞洛导致一名62岁急性冠脉综合征女性血管成形术后发生窦房传导阻滞
Tex Heart Inst J. 2019 Jun 1;46(3):203-206. doi: 10.14503/THIJ-17-6554. eCollection 2019 Jun.
7
Adenosine and the Cardiovascular System.腺嘌呤核苷与心血管系统。
Am J Cardiovasc Drugs. 2019 Oct;19(5):449-464. doi: 10.1007/s40256-019-00345-5.
8
Inverse agonism at the P2Y12 receptor and ENT1 transporter blockade contribute to platelet inhibition by ticagrelor.替格瑞洛对血小板的抑制作用源于其对P2Y12受体的反向激动作用以及对ENT1转运体的阻断作用。
Blood. 2016 Dec 8;128(23):2717-2728. doi: 10.1182/blood-2016-03-707844. Epub 2016 Sep 30.
9
Identifying cases of heroin toxicity where 6-acetylmorphine (6-AM) is not detected by toxicological analyses.识别毒理学分析未检测到6-乙酰吗啡(6-AM)的海洛因中毒病例。
Forensic Sci Med Pathol. 2016 Sep;12(3):243-7. doi: 10.1007/s12024-016-9780-2. Epub 2016 Apr 25.
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J Cardiovasc Pharmacol Ther. 2014 Mar;19(2):209-19. doi: 10.1177/1074248413511693. Epub 2014 Jan 10.