Ticagrelor is a frequent component of dual antiplatelet therapy (DAPT) following carotid artery stent placement. Hemorrhagic complications remain the focus of most reports, however, other adverse events must also be known to the prescribing physician. Angioedema is a rare and potentially life-threatening complication reported following ticagrelor administration and we present 1 such case here with a review of the existing literature.
FarbABoamAB. Stent thrombosis redux — The FDA perspective. N Engl J Med. 2007;356(10):984-987. doi:10.1056/nejmp068304
2.
OlafsonEMDeGroteJRDrofaA, et al.A case series of 18 patients receiving ticagrelor after carotid stenting. J Pharm Pract. 2018;31(5):519-521. doi:10.1177/0897190017729524
3.
HeldCÅsenbladNBassandJP, et al.Ticagrelor versus clopidogrel in patients with acute coronary syndromes undergoing coronary artery bypass surgery: Results from the PLATO (platelet inhibition and patient outcomes) trial. J Am Coll Cardiol. 2011;57(6):672-684. doi:10.1016/j.jacc.2010.10.029
4.
QuinnKLConnellyKA. First report of hypersensitivity to ticagrelor. Can J Cardiol. 2014;30(8):957.e3-957. doi:10.1016/j.cjca.2014.04.011
5.
BernsteinJACremonesiPHoffmannTKHollingsworthJ. Angioedema in the emergency department: A practical guide to differential diagnosis and management. Int J Emerg Med. 2017;10(1):15. doi:10.1186/s12245-017-0141-z
6.
BanerjiAClarkSBlandaMLoVecchioFSnyderBCamargoCA. Multicenter study of patients with angiotensin-converting enzyme inhibitor-induced angioedema who present to the emergency department. Ann Allergy, Asthma Immunol. 2008;100(4):327-332. doi:10.1016/S1081-1206(10)60594-7
7.
HillMDLyeTMossH, et al.Hemi-orolingual angioedema and ACE inhibition after alteplase treatment of stroke. Neurology. 2003;60(9):1525-1527. doi:10.1212/01.WNL.0000058840.66596.1A
8.
SeecheranRSeecheranVPersadSLallaSSeecheranNA. Ticagrelor-induced angioedema: A rare and unexpected phenomenon. Case Rep Cardiol. 2017;2017:7612713. doi:10.1155/2017/7612713
9.
PiranavanPKaurNJMarmoushFBurtonAHannanJ. Ticagrelor-induced angioedema after percutaneous coronary intervention in a patient with a history of ischemic stroke and low response to clopidogrel: A rare dilemma. Cureus. 2018;10(12):e3720. doi:10.7759/cureus.3720
10.
DohertyMJ. Algorithms for assessing the probability on an adverse drug reaction. Respiratory Medicine CME. 2009; 2(2): 63-67. DOI: 10.1016/j.rmedc.2009.01.004.
11.
NaranjoCABustoUSellersEM, et al.A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981; 30(2): 239–245. doi:10.1038/clpt.1981.154.
12.
KramerMSHutchinsonTA. The Yale algorithm special workshop--Clinical. Drug Inform J. 1984; 18: 283–291. doi:10.1177/009286158401800315.