Logo image
Back
ACCELERATED ATHEROSCLEROSIS AFTER TREATMENT WITH NINTEDANIB
Abstract   Peer reviewed

ACCELERATED ATHEROSCLEROSIS AFTER TREATMENT WITH NINTEDANIB

Caleb Chiang, Claudia Lama von Buchwald, Abhaya Trivedi and Hussam S. Suradi
Journal of the American College of Cardiology, Vol.79(9 suppl), pp.2967-2967
03/08/2022
DOI: 10.1016/S0735-1097(22)03958-4

View Online

Abstract

Background: Nintedanib is a tyrosine kinase inhibitor (TKI) used to treat idiopathic pulmonary fibrosis (IPF). Nintedanib has been associated with a higher incidence of myocardial infarction (MI) in prior clinical studies. Case: A 59-year-old man with a history of primary sclerosing cholangitis status post liver transplant, diastolic heart failure, and IPF presented with chest pain, nausea and diaphoresis. He had a coronary angiogram two years prior, without evidence of any angiographic coronary artery disease (Panel A). Decision-making: He was admitted to the cardiac intensive care unit and treated for NSTEMI. Coronary angiography showed left anterior descending artery (LAD) with 50-60% mid lesion, 1st diagonal with 90% ostial lesion, and mid-right coronary artery (RCA) with a 90% stenosis (Panel B). Two drug-eluting stents were placed in the RCA, with a plan for a staged intervention to the LAD. In the absence of other traditional risk factors, the patient’s accelerated coronary artery disease was attributed to Nintedanib and it was discontinued. TKIs are associated with ischemic heart disease and increased risk of acute coronary syndrome, particularly in patients with underlying cardiac risk factors. This is possibly due to weakening the fibrous cap. Conclusion: Nintedanib has been associated with an increased incidence of ischemic heart disease and plaque rupture. Close cardiovascular monitoring may be necessary in patients treated with Nintedanib.

Details

Metrics

1 Record Views
Logo image