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Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention

Caesarean section is a challenging intervention in patients treated with dual antiplatelet therapy. We present a case of a 32-year-old pregnant woman experiencing large acute myocardial infarction (MI) of the anterolateral wall, complicated by cardiogenic shock in the 38th week of pregnancy, and tre...

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Autores principales: Antonijevic, Nebojsa, Mitrovic, Predrag, Gosnjic, Nikola, Orlic, Dejan, Kadija, Sasa, Ilic Mostic, Tanja, Savic, Nebojsa, Birovljev, Ljubica, Lekovic, Zaklina, Matic, Dragan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532752/
https://www.ncbi.nlm.nih.gov/pubmed/37763112
http://dx.doi.org/10.3390/jpm13091344
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author Antonijevic, Nebojsa
Mitrovic, Predrag
Gosnjic, Nikola
Orlic, Dejan
Kadija, Sasa
Ilic Mostic, Tanja
Savic, Nebojsa
Birovljev, Ljubica
Lekovic, Zaklina
Matic, Dragan
author_facet Antonijevic, Nebojsa
Mitrovic, Predrag
Gosnjic, Nikola
Orlic, Dejan
Kadija, Sasa
Ilic Mostic, Tanja
Savic, Nebojsa
Birovljev, Ljubica
Lekovic, Zaklina
Matic, Dragan
author_sort Antonijevic, Nebojsa
collection PubMed
description Caesarean section is a challenging intervention in patients treated with dual antiplatelet therapy. We present a case of a 32-year-old pregnant woman experiencing large acute myocardial infarction (MI) of the anterolateral wall, complicated by cardiogenic shock in the 38th week of pregnancy, and treated with drug-eluting stent implantation and dual antiplatelet therapy (DAPT) consisting of aspirin and ticagrelor. Less than 24 h after the MI delivery started, an urgent Caesarean section was indicated. As multiplate aggregometry testing showed a relatively insufficient level of ticagrelor platelet inhibition and a moderate level of aspirin platelet inhibition, a Caesarean section was performed without discontinuation of ticagrelor, which was decided due to the need for emergency surgery. Local hemostatic measures including administration of tranexamic acid were applied. The patient did not experience excessive bleeding. A healthy male baby was born. To the best of our knowledge, this is the first reported case of surgery in pregnant women treated with DAPT without ticagrelor discontinuation.
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spelling pubmed-105327522023-09-28 Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention Antonijevic, Nebojsa Mitrovic, Predrag Gosnjic, Nikola Orlic, Dejan Kadija, Sasa Ilic Mostic, Tanja Savic, Nebojsa Birovljev, Ljubica Lekovic, Zaklina Matic, Dragan J Pers Med Case Report Caesarean section is a challenging intervention in patients treated with dual antiplatelet therapy. We present a case of a 32-year-old pregnant woman experiencing large acute myocardial infarction (MI) of the anterolateral wall, complicated by cardiogenic shock in the 38th week of pregnancy, and treated with drug-eluting stent implantation and dual antiplatelet therapy (DAPT) consisting of aspirin and ticagrelor. Less than 24 h after the MI delivery started, an urgent Caesarean section was indicated. As multiplate aggregometry testing showed a relatively insufficient level of ticagrelor platelet inhibition and a moderate level of aspirin platelet inhibition, a Caesarean section was performed without discontinuation of ticagrelor, which was decided due to the need for emergency surgery. Local hemostatic measures including administration of tranexamic acid were applied. The patient did not experience excessive bleeding. A healthy male baby was born. To the best of our knowledge, this is the first reported case of surgery in pregnant women treated with DAPT without ticagrelor discontinuation. MDPI 2023-08-30 /pmc/articles/PMC10532752/ /pubmed/37763112 http://dx.doi.org/10.3390/jpm13091344 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Antonijevic, Nebojsa
Mitrovic, Predrag
Gosnjic, Nikola
Orlic, Dejan
Kadija, Sasa
Ilic Mostic, Tanja
Savic, Nebojsa
Birovljev, Ljubica
Lekovic, Zaklina
Matic, Dragan
Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention
title Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention
title_full Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention
title_fullStr Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention
title_full_unstemmed Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention
title_short Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention
title_sort successful caesarean section on ticagrelor treatment one day after primary percutaneous coronary intervention
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532752/
https://www.ncbi.nlm.nih.gov/pubmed/37763112
http://dx.doi.org/10.3390/jpm13091344
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