Key result
Ticagrelor induces reversible central sleep apnea, preventing ventilator weaning in a stent thrombosis case.
Why the study?
Ticagrelor use is associated with dyspnea, but its role as a cause of central sleep apnea in ventilated patients is not well recognized.
Case Report (n=1)
This case highlights ticagrelor as a potential rare cause of central sleep apnea that should be considered in ventilated patients experiencing difficult weaning.
Ticagrelor may cause reversible central sleep apnea in ventilated patients; single case leaves open need for prospective confirmation before clinical consideration.
Ticagrelor is an orally administered P2Y12-receptor antagonist with more potent inhibition of platelet aggregation than clopidogrel. There is an association between ticagrelor use and dyspnea. We present a complex patient with stent thrombosis on clopidogrel and multiple comorbidities who was initiated on ticagrelor, with subsequent development of central sleep apnea, though reported in the literature but was not considered the cause of central sleep apnea initially. This adverse effect was suspected late, as he was unable to be weaned off the ventilator and had documented apnea events. On discontinuing ticagrelor, apnea episodes ceased. This case cautions cardiologists and other physicians about this rare complication of ticagrelor, which needs to be considered as a possible cause of central sleep apnea in patients on a ventilator with difficult weaning.
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Panduranga et al. (2026) conducted a case report in Stent thrombosis and ventilator dependence (n=1). Ticagrelor was evaluated on Development of central sleep apnea. Ticagrelor administration induced central sleep apnea in a ventilated patient with stent thrombosis, which completely resolved upon discontinuation of the drug.
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