Author/Authors :
Ray, Avik Department of Pharmacology - All India Institute of Medical Sciences Bhopal, Saket Nagar, Bhopal, Madhya Pradesh, India , Najmi, Ahmad Department of Pharmacology - All India Institute of Medical Sciences Bhopal, Saket Nagar, Bhopal, Madhya Pradesh, India , Khandelwal, Gaurav Department of Cardiology - All India Institute of Medical Sciences Bhopal, Saket Nagar, Bhopal, Madhya Pradesh, India , Sadasivam, Balakrishnan Department of Pharmacology - All India Institute of Medical Sciences Bhopal, Saket Nagar, Bhopal, Madhya Pradesh, India
Abstract :
Background. Ticagrelor has been accepted as a class I antiplatelet agent in patients undergoing percutaneous coronary angioplasty
(PTCA). There have been cases reported on ticagrelor being associated with various cardiac conduction defects. But there is no
evidence of QTc prolongation associated with the drug as of yet. Case Presentation. A 64-year-old male who underwent PTCA
was given ticagrelor. A baseline electrocardiogram (ECG) showed a QTc of 402 ms. He returned after 1.5 months with
complaints of shortness of breath. An ECG revealed a prolonged QTc of 468 ms. Ticagrelor was discontinued in view of
ticagrelor-induced dyspnea and the patient was started on clopidogrel. The other medications were kept unchanged. The
patient returned after a month without any complaints. A follow-up ECG showed a reduced QTc of 425 ms. Conclusion. We
present a case of ticagrelor-induced QTc prolongation. To our knowledge, this is the first case to be reported on the same. The
Naranjo algorithm for causality assessment gave a total score of 6 indicating that the adverse drug reaction falls under the
probable category
