Acute myocardial infarction following inhaled treprostinil initiation

An 81-year-old man with a history of interstitial lung disease attributed to idiopathic pulmonary fibrosis, severe aortic stenosis, and stable coronary artery disease was started on inhaled treprostinil for pulmonary hypertension associated with interstitial lung disease to optimize hemodynamics pri...

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Main Authors: Bilal Alqam, Sarah Medrek
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Respiratory Medicine Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2213007125000206
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author Bilal Alqam
Sarah Medrek
author_facet Bilal Alqam
Sarah Medrek
author_sort Bilal Alqam
collection DOAJ
description An 81-year-old man with a history of interstitial lung disease attributed to idiopathic pulmonary fibrosis, severe aortic stenosis, and stable coronary artery disease was started on inhaled treprostinil for pulmonary hypertension associated with interstitial lung disease to optimize hemodynamics prior to the valve replacement procedure. However, two days after starting this treatment, the patient presented with an inferior-posterior ST elevation myocardial infarction. Urgent coronary angiography revealed a 95 % proximal right coronary artery stenosis, successfully treated with percutaneous coronary intervention and drug-eluting stent placement. This case raises a question of whether there could be a potential association between inhaled treprostinil initiation and acute myocardial infarction in patients with underlying coronary artery disease. With the documented stability of the patient's coronary artery disease prior to medication initiation, it is plausible to question whether treprostinil may have played a role in plaque destabilization.
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spelling doaj-art-d2cc4bd6a9894a2f824bbd0909ce0da12025-08-20T03:44:21ZengElsevierRespiratory Medicine Case Reports2213-00712025-01-015410218410.1016/j.rmcr.2025.102184Acute myocardial infarction following inhaled treprostinil initiationBilal Alqam0Sarah Medrek1Division of Cardiology, University of New Mexico Health Sciences Center, Albuquerque, NM, USADivision of Pulmonary, Critical Care, Sleep Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; Division of Pulmonary, Critical Care, Sleep Medicine, New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA; Corresponding author. Section Chief of Pulmonary, Critical Care, Sleep Medicine at NMVAHCS University of New Mexico School of Medicine 1501 San Pedro Dr SE Building 41, Room 5B-121 Albuquerque, NM 87108, USA.An 81-year-old man with a history of interstitial lung disease attributed to idiopathic pulmonary fibrosis, severe aortic stenosis, and stable coronary artery disease was started on inhaled treprostinil for pulmonary hypertension associated with interstitial lung disease to optimize hemodynamics prior to the valve replacement procedure. However, two days after starting this treatment, the patient presented with an inferior-posterior ST elevation myocardial infarction. Urgent coronary angiography revealed a 95 % proximal right coronary artery stenosis, successfully treated with percutaneous coronary intervention and drug-eluting stent placement. This case raises a question of whether there could be a potential association between inhaled treprostinil initiation and acute myocardial infarction in patients with underlying coronary artery disease. With the documented stability of the patient's coronary artery disease prior to medication initiation, it is plausible to question whether treprostinil may have played a role in plaque destabilization.http://www.sciencedirect.com/science/article/pii/S2213007125000206Pulmonary hypertensionAcute myocardial infarctionProstacyclin analogue
spellingShingle Bilal Alqam
Sarah Medrek
Acute myocardial infarction following inhaled treprostinil initiation
Respiratory Medicine Case Reports
Pulmonary hypertension
Acute myocardial infarction
Prostacyclin analogue
title Acute myocardial infarction following inhaled treprostinil initiation
title_full Acute myocardial infarction following inhaled treprostinil initiation
title_fullStr Acute myocardial infarction following inhaled treprostinil initiation
title_full_unstemmed Acute myocardial infarction following inhaled treprostinil initiation
title_short Acute myocardial infarction following inhaled treprostinil initiation
title_sort acute myocardial infarction following inhaled treprostinil initiation
topic Pulmonary hypertension
Acute myocardial infarction
Prostacyclin analogue
url http://www.sciencedirect.com/science/article/pii/S2213007125000206
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AT sarahmedrek acutemyocardialinfarctionfollowinginhaledtreprostinilinitiation