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Tegaserod-induced myocardial infarction: case report and hypothesis.
Anthony J Busti1, Jose R Murillo, Byron Cryer
1School of Pharmacy-Dallas/Ft. Worth Regional Campus, Texas Tech University Health Sciences Center, Dallas, Texas 75216, USA. anthony.busti@ttuhsc.edu
Pharmacotherapy
|April 22, 2004
Summary
Serotonin 5-HT1 receptor agonists, like those for migraines, can cause heart issues. This case shows tegaserod, a 5-HT4 agonist, may also pose cardiovascular risks.
Area of Science:
- Pharmacology
- Cardiology
- Gastroenterology
Background:
- Serotonin (5-hydroxytryptamine [5-HT])1 receptor agonists are known to cause coronary artery contraction and myocardial infarction.
- Tegaserod maleate is a 5-HT4 receptor agonist with moderate 5-HT1 receptor affinity, approved for irritable bowel syndrome and used for gastroparesis.
Observation:
- A case report details a man experiencing myocardial infarction after two 6-mg doses of tegaserod.
- This event is hypothesized to be linked to tegaserod's 5-HT1 receptor activity.
Findings:
- Tegaserod, despite being a 5-HT4 agonist, demonstrated potential for 5-HT1 mediated cardiovascular adverse events.
- The patient experienced a myocardial infarction following minimal exposure to tegaserod.
Implications:
- Clinicians should consider the potential for cardiovascular adverse events when prescribing tegaserod.
- A thorough review of patient cardiovascular risk factors is crucial before initiating treatment with 5-HT1 receptor agonist activity drugs.