Ticagrelor is a potent, direct-acting, and reversible P2Y12‑adenosine diphosphate receptor blocker. It has a rapid onset of action and an intense and consistent platelet reactivity inhibition that has been demonstrated to be superior to clopidogrel in decreasing major adverse events in acute coronary syndrome (ACS). Although ticagrelor is well tolerated in ACS patients, it has side effects, such as dyspnea and bradyarrhythmia, as reported in the Platelet Inhibition and Patient Outcomes (PLATO) study. Furthermore, it was reported that ticagrelor's bradyarrhythmic potential was transient and not clinically significant beyond the acute initiation phase. Nor was there a difference in rates of syncope or need for pacemaker insertion during 30 days of follow-up. Here we report a case of ticagrelor associated with Cheyne-Stokes respiration and asystolic ventricular standstill in a patient with ACS who required resuscitation and insertion of a temporary pacemaker.
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http://dx.doi.org/10.18087/cardio.2024.2.n2123 | DOI Listing |
Respir Res
January 2025
HP2 Laboratory, Inserm Unit 1300, University Grenoble Alpes, Grenoble, France.
The Alertapnée study followed 555 adults with obstructive sleep apnea treated with CPAP and found that the occurrence of Cheyne-Stokes respiration (CSR) was linked to a 14-fold increase in the risk of significant cardiac events (SCE) after one year. However, the progression and clinical significance of CSR episodes over time remain unclear. This ancillary study aimed to assess CSR progression and clinical outcomes during a second year of follow-up in 66 patients who had experienced at least one CSR episode in the first year.
View Article and Find Full Text PDFJ Clin Med
November 2024
Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Clinic Floridsdorf, 1210 Vienna, Austria.
Impairment in autonomic activity is a prognostic marker in patients with heart failure (HF), and its involvement has been suggested in cardiovascular complications of obstructive sleep apnea syndrome (OSAS) and Cheyne-Stokes respiration (CSR). This prospective observational study aims to investigate the implications of sleep-disordered breathing (SDB) on hemodynamic regulation and autonomic activity in chronic HF patients. Chronic HF patients, providing confirmation of reduced ejection fraction (≤35%), underwent polysomnography, real-time hemodynamic, heart rate variability (HRV), and baroreceptor reflex sensitivity (BRS) assessments using the Task Force Monitor.
View Article and Find Full Text PDFEur Respir Rev
October 2024
University Hospital Essen, Ruhrlandklinik, Center for Sleep- and Telemedicine, Essen, Germany.
https://bit.ly/4dAfQdP
View Article and Find Full Text PDFMath Biosci
December 2024
Center for Applied Medical Analytics, University of Virginia, Charlottesville, VA 240918, United States; Butterfly Dynamics LLC, 3017 Spotswood Cay, Williamsburg, VA 23185, United States. Electronic address:
Cheyne-Stokes Breathing is a periodic cycle of apnea followed by hyperventilation. A theory of this phenomenon is developed based on a minimal set of physiological assumptions. The rate of loss of CO from venous blood is proportional to the CO concentration in the lungs times the respiration rate; the respiration rate is a linear function of arterial CO concentration above a threshold, and zero below that threshold.
View Article and Find Full Text PDFEur J Prev Cardiol
September 2024
Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.
Aims: Central (CA) and obstructive apneas (OA) are highly prevalent in patients with chronic heart failure (HF) and transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized HF etiology. This study aimed to investigate the prevalence and impact of CA and OA in patients with ATTR-CA.
Methods: Consecutive patients with ATTR-CA underwent a 24-hour ambulatory cardiorespiratory monitoring to evaluate the prevalence and severity of breathing disorders.
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