Effect of altitude on ticagrelor-induced dyspnea in patients with acute coronary syndrome

Author:

Kocabay Gonenc1,Kivrak Tarik2ORCID,Karaca Ozkan2,Karasu Mehdi2,Kaya Hakki3,Kanar Batur4,Orscelik Ozcan5,Kobat Mehmet Ali2,Yilmaz Mehmet Birhan6

Affiliation:

1. Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey

2. Firat University, Department of Cardiology, Elazig, Turkey

3. Cumhuriyet University, Department of Cardiology, Sivas, Turkey

4. Marmara University, Department of Cardiology, Istanbul, Turkey

5. Mersın University, Department of Cardiology, Mersin, Turkey

6. Dokuz Eylül University, Department of Cardiology, Izmir, Turkey

Abstract

Objective This study aimed to define the association between altitude and ticagrelor-associated dyspnea in patients with acute coronary syndrome (ACS). Methods We studied consecutive patients with de novo ACS who were admitted to two centers at a low altitude (18 and 25 m, n = 65) and two centers at a high altitude (1313 and 1041 m, n = 136). We managed them with ticagrelor between May 2017 and September 2017. Patients with ACS underwent an interventional procedure within <90 minutes in those with ST elevation and within <3 hours in those without ST elevation. We recorded the incidence of dyspnea in patients with ACS receiving ticagrelor therapy. Results The mean age was 59.5 ± 10 years, and the mean ejection fraction was 43% ± 18%. A total of 110 (56.7%) patients had ST elevation and 84 (43.3%) did not. There were no significant differences in cardiac risk factors, concurrent medications, or procedural variables between the two groups. Dyspnea developed during hospitalization in 53 (38%) patients from high-altitude centers and in 13 (20%) patients from low-altitude centers (66 patients represented 32% of the total ACS cohort). Conclusions Dyspnea is a common multifactorial symptom in patients following development of ACS. Ticagrelor-induced dyspnea appears to be associated with altitude.

Publisher

SAGE Publications

Subject

Biochemistry (medical),Cell Biology,Biochemistry,General Medicine

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