Ticagrelor-induced acute kidney injury can increase serum concentration of statin and lead to concurrence of rhabdomyolysis

The 2016 American Heart Association/American College of Cardiology guidelines advise the use of dual antiplatelet agents for patients with acute coronary syndrome (ACS) (1). Ticagrelor is a reversible oral antagonist of the ADP receptor P2Y12. It is rapidly absorbed and metabolized by cytochrome P450 (CYP) 3A4. Therefore, ticagrelor suggests a potential for drug interactions with other CYP3A4 substrates (2). Statins are recommended for preventing cardiovascular disease after ACS (3). These statins are associated with myalgia; elevation of creatine phosphokinase (CK) concentrations; and rarely, rhabdomyolysis. Rhabdomyolysis caused by statins is susceptible to occur when the renal function is impaired (4). Here we describe a patient in whom ticagrelor-induced acute kidney injury (AKI) increased the serum concentration of statin and then, eventually, led to concurrence of rhabdomyolysis.