{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T23:55:25Z","timestamp":1772582125031,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ticagrelor is a widely used P2Y12 inhibitor and represents a fundamental therapeutic agent in acute coronary syndrome treatment and selected post-percutaneous coronary intervention (PCI) cases. Dyspnoea and bradycardia are the most common side effects but the latter has been reported to be of trivial clinical significance<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 51-year-old gentleman underwent PCI to left anterior descending and obtuse marginal for unstable angina receiving a loading dose of ticagrelor (180\u2009mg). During hospital stay, whilst on telemetry monitoring, a 16\u2009s long, symptomatic, asystolic ventricular standstill was recorded prompting ticagrelor interruption and a switch to prasugrel.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Despite ventricular pauses have been reported in dedicated analyses of Phase III trials, no apparent clinical consequences were documented. However, several reports have shown that significant brady-arrhythmic events might be linked to ticagrelor administration presenting both as sino-atrial and atrio-ventricular conduction disturbances. We report a case of asystole occurring 36\u2009h after the administration of a loading dose.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa156","type":"journal-article","created":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T05:18:20Z","timestamp":1597900700000},"page":"1-5","source":"Crossref","is-referenced-by-count":3,"title":["A rare but serious complication of ticagrelor therapy: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6597-9166","authenticated-orcid":false,"given":"Manfredi","family":"Arioti","sequence":"first","affiliation":[{"name":"Dipartimento di Cardiologia, Policlinico San Marco, Zingonia, Gruppo San Donato"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8863-5312","authenticated-orcid":false,"given":"Giovanni","family":"Sirianni","sequence":"additional","affiliation":[{"name":"Dipartimento di Cardiologia, Policlinico San Marco, Zingonia, Gruppo San Donato"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7735-0928","authenticated-orcid":false,"given":"Maria Luisa","family":"Laudisa","sequence":"additional","affiliation":[{"name":"Dipartimento di Cardiologia, Policlinico San Marco, Zingonia, Gruppo San Donato"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6533-7243","authenticated-orcid":false,"given":"Nicoletta Bianca","family":"De Cesare","sequence":"additional","affiliation":[{"name":"Dipartimento di Cardiologia, Policlinico San Marco, Zingonia, Gruppo San Donato"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,8,20]]},"reference":[{"key":"2020110901525638900_ytaa156-B1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1093\/eurheartj\/ehv320","article-title":"2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)","volume":"37","author":"Roffi","year":"2016","journal-title":"Eur Heart J"},{"key":"2020110901525638900_ytaa156-B2","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1002\/phar.1477","article-title":"Ticagrelor: pharmacokinetics, pharmacodynamics, clinical efficacy, and safety","volume":"34","author":"Dobesh","year":"2014","journal-title":"Pharmacotherapy"},{"key":"2020110901525638900_ytaa156-B3","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1056\/NEJMoa0904327","article-title":"Ticagrelor versus clopidogrel in patients with acute coronary syndromes","volume":"361","author":"Wallentin","year":"2009","journal-title":"N Engl J 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monitoring","volume":"2017","author":"Sharma","year":"2017","journal-title":"Case Rep Cardiol"},{"key":"2020110901525638900_ytaa156-B7","doi-asserted-by":"crossref","first-page":"602","DOI":"10.7326\/L17-0550","article-title":"Prolonged asystole after a loading dose of ticagrelor","volume":"168","author":"Rosset","year":"2018","journal-title":"Ann Intern Med"},{"key":"2020110901525638900_ytaa156-B8","article-title":"Ticagrelor-associated ventricular pauses: a case report and literature review","volume":"3","author":"Low","year":"2019","journal-title":"Eur Heart J Case Rep"},{"key":"2020110901525638900_ytaa156-B9","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1016\/j.ijcard.2015.08.200","article-title":"Ticagrelor therapy in patients with advanced conduction disease: is it really safe?","volume":"202","author":"Goldberg","year":"2016","journal-title":"Int J 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