Display options
Cite
Di Serafino L, Rotolo FL, Boggi A, et al. Potential additive effects of ticagrelor, ivabradine, and carvedilol on sinus node. Case Rep Cardiol. 2014;2014:932595doi: 10.1155/2014/932595.
Di Serafino, L., Rotolo, F. L., Boggi, A., Colantonio, R., Serdoz, R., & Monti, F. (2014). Potential additive effects of ticagrelor, ivabradine, and carvedilol on sinus node. Case reports in cardiology, 2014932595. https://doi.org/10.1155/2014/932595
Di Serafino, Luigi, et al. "Potential additive effects of ticagrelor, ivabradine, and carvedilol on sinus node." Case reports in cardiology vol. 2014 (2014): 932595. doi: https://doi.org/10.1155/2014/932595
Di Serafino L, Rotolo FL, Boggi A, Colantonio R, Serdoz R, Monti F. Potential additive effects of ticagrelor, ivabradine, and carvedilol on sinus node. Case Rep Cardiol. 2014;2014:932595. doi: 10.1155/2014/932595. Epub 2014 Sep 29. PMID: 25328715; PMCID: PMC4195349.
Copy Download .nbib Format: NLM
Share it on

Case Rep Cardiol. 2014;2014:932595. doi: 10.1155/2014/932595. Epub 2014 Sep 29.

Potential additive effects of ticagrelor, ivabradine, and carvedilol on sinus node.

Case reports in cardiology

Luigi Di Serafino, Francesco Luigi Rotolo, Augusto Boggi, Riccardo Colantonio, Roberto Serdoz, Francesco Monti

Affiliations

  1. Division of Cardiology, Ospedale San Pietro Fatebenefratelli, 00189 Rome, Italy ; Division of Cardiology, P.O. Di Venere, Via Ospedale di Venere, No. 1, 70131 Bari, Italy.
  2. Division of Cardiology, Ospedale San Pietro Fatebenefratelli, 00189 Rome, Italy.

PMID: 25328715 PMCID: PMC4195349 DOI: 10.1155/2014/932595

Abstract

A 51-year-old male patient presented to the emergency room with an anterior ST-elevation myocardial infarction. After a loading dose of both ticagrelor and aspirin, the patient underwent primary-PCI on the left anterior descending coronary artery with stent implantation. After successful revascularization, medical therapy included beta-blockers, statins, and angiotensin II receptor antagonists. Two days later, ivabradine was also administered in order to reduce heart rate at target, but the patient developed a severe symptomatic bradycardia and sinus arrest, even requiring administration of both atropine and adrenaline. Ivabradine and ticagrelor have been then suspended and this latter changed with prasugrel. Any other similar event was not reported during the following days. This clinical case raised concerns about the safety of the combination of beta-blockers and ivabradine in patients treated with ticagrelor, particularly during the acute phase of an acute coronary syndrome. These two latter drugs, in particular, might interact with the same receptor. In fact, ivabradine directly modulates the If-channel which is also modulated by the cyclic adenosine monophosphate levels. These latter have been shown to increase after ticagrelor assumption via inhibition of adenosine uptake by erythrocytes. Further studies are warrant to better clarify the safety of this association.

References

  1. FASEB J. 1995 Mar;9(5):359-65 - PubMed
  2. J Physiol. 1988 Nov;405:615-33 - PubMed
  3. Nature. 1991 May 9;351(6322):145-7 - PubMed
  4. J Am Coll Cardiol. 2007 Nov 6;50(19):1844-51 - PubMed
  5. Physiol Rev. 1990 Jul;70(3):761-845 - PubMed
  6. Lancet. 2008 Sep 6;372(9641):807-16 - PubMed
  7. Pflugers Arch. 1985 Jan;403(1):75-81 - PubMed
  8. N Engl J Med. 2009 Sep 10;361(11):1045-57 - PubMed
  9. Eur Heart J. 2005 May;26(10):967-74 - PubMed
  10. Cardiovasc Drugs Ther. 2009 Jun;23(3):243-7 - PubMed

Publication Types