Why the study?
Does oral desmopressin induce coronary spastic angina in patients with potential endothelial dysfunction?
Does oral desmopressin induce coronary spastic angina in patients with potential endothelial dysfunction?
Oral desmopressin may provoke coronary vasospasm in patients with potential endothelial dysfunction, highlighting the need for caution when prescribing it.
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Desmopressin may associate with coronary spasm in endothelial dysfunction; case report leaves open causality and need for prospective study.
A 60-year-old man was prescribed oral desmopressin (1-deamino-8-D-arginine vasopressin acetate trihydrate; DDAVP) for nocturnal polyuria. One week after starting to take desmopressin, he frequently felt chest pain while resting. Coronary angiography revealed no organic stenosis; however, an acetylcholine provocation test showed severe coronary spasm with ST elevation. He was diagnosed with coronary spastic angina, and we stopped the oral desmopressin and added diltiazem. While DDAVP should dilate the coronary vessels in healthy subjects, it may provoke coronary vasospasm in patients with endothelial dysfunction. We should be careful to avoid triggering coronary spasm when administering DDAVP to patients that may have potential endothelial dysfunction.
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Adachi et al. (2016) studied this question.
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