Cargando…
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...
Autores principales: | , , , , , , , , , |
---|---|
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 |
_version_ | 1785112035046981632 |
---|---|
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. |
format | Online Article Text |
id | pubmed-10532752 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT antonijevicnebojsa successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention AT mitrovicpredrag successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention AT gosnjicnikola successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention AT orlicdejan successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention AT kadijasasa successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention AT ilicmostictanja successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention AT savicnebojsa successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention AT birovljevljubica successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention AT lekoviczaklina successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention AT maticdragan successfulcaesareansectiononticagrelortreatmentonedayafterprimarypercutaneouscoronaryintervention |