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Ticagrelor-induced sinus pause: an adenosine-driven side effect

delete2026-01-12
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OA
AI
F
Fanning, John Keenan *
B
Barnes, Andrew Austin Bowerman
B
Betley, Fraser
S
Sondhi, Sachin
DOI:10.1136/bcr-2025-266221delete
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Abstract

Abstract

En 中文
Dual anti-platelet therapy remains a cornerstone of the treatment for coronary artery disease. When choosing a second anti-platelet, ticagrelor remains a principal agent after the recent PLATO trial showed its superiority in reducing the incidence of stent thrombosis compared with clopidogrel. Despite this, ticagrelor has been shown to have side effects not seen by other anti-platelets, including shortness of breath, bradycardia and sinus pauses. These side effects are thought to be due to ticagrelor's second molecular target, human equilibrative nucleoside transporter 1, which leads to an increase in extracellular adenosine levels. This rise in adenosine is thought to trigger these adverse effects. This case report presents an example of an individual who has experienced these adenosine-driven side effects after starting ticagrelor and provides a review of the underlying adenosine-driven mechanisms.
Keywords:
Adenosine Deaminase
Ischaemic heart disease
Pacing and electrophysiology
Venous thromboembolism
Cardiovascular system

Journal

BMJ Case Reports cover
BMJ Case Reports
IF:
0.5
Papers:
1.1K
Citations:
1.2W

Organization

M
mackay base hospital
Scholars:
50
Papers: 44
Citations: 0
Q
Queensland Health
Scholars:
1.9K
Papers: 1.3K
Citations: 1.1K