Antonijevic, N.; Mitrovic, P.; Gosnjic, N.; Orlic, D.; Kadija, S.; Ilic Mostic, T.; Savic, N.; Birovljev, L.; Lekovic, Z.; Matic, D. Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention. J. Pers. Med.2023, 13, 1344.
Antonijevic, N.; Mitrovic, P.; Gosnjic, N.; Orlic, D.; Kadija, S.; Ilic Mostic, T.; Savic, N.; Birovljev, L.; Lekovic, Z.; Matic, D. Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention. J. Pers. Med. 2023, 13, 1344.
Antonijevic, N.; Mitrovic, P.; Gosnjic, N.; Orlic, D.; Kadija, S.; Ilic Mostic, T.; Savic, N.; Birovljev, L.; Lekovic, Z.; Matic, D. Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention. J. Pers. Med.2023, 13, 1344.
Antonijevic, N.; Mitrovic, P.; Gosnjic, N.; Orlic, D.; Kadija, S.; Ilic Mostic, T.; Savic, N.; Birovljev, L.; Lekovic, Z.; Matic, D. Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention. J. Pers. Med. 2023, 13, 1344.
Abstract
Cesarean section is a challenge intervention in patients treated with dual antiplatelet therapy. We present case of 32 years old pregnant woman experiencing large acute myocardial infarction (MI) of anterolateral wall complicated by cardiogenic shock in the 38th week of pregnancy treated with drug-eluting stent implantation and dual antiplatelet therapy (DAPT) consisting of aspirin and ticagrelor. Less than 24 hours after MI delivery started, 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, 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.
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
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