title: Taking varenicline for smoking cessation: A rare cause of pulmonary thromboembolism with infarction.
abstract: Varenicline (Champix®, Chantix®) is a partial agonist of the α4β2 nicotinic acetylcholine receptor (nAChR) and a full agonist of the α7 nAChR. It has been used for smoking cessation since 2006. Varenicline has been associated with adverse cardiovascular (CV) events, including myocardial infarction, which may be caused by activation of the α7 nAChR receptor that in turn stimulates parasympathetic output from the brainstem to the heart, release of catecholamines, and has a prothrombotic effect. However, among the adverse CV events, the issue related to the varenicline-induced pulmonary thromboembolism (PTE) has not being addressed. We report a case of PTE with pulmonary infarction presenting as right flank pain that resulted from the use of varenicline (the total score of adverse drug reaction probability scale, 6; probable association between varenicline and pulmonary PTE) in a patient without underlying CV disease and in whom low probability of PTE (Wells score was zero) was identified.
authors.affiliation: Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Republic of Korea.
authors.forename: Sun Hwa
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, PO Box 335-21, 635 Danjae-ro, Namil-myeon, Cheongwon-gun, Chungcheongbuk-do 363-849, Republic of Korea. Electronic address: zoomknight@naver.com.
authors.forename: Seong Jong
authors.initials: SJ
authors.lastname: Yun
authors.affiliation: Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Republic of Korea.
authors.forename: Seokyong
authors.initials: S
authors.lastname: Ryu
authors.affiliation: Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Republic of Korea.
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Choi
authors.affiliation: Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Republic of Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Republic of Korea.
authors.forename: Tae Kyug
authors.initials: TK
authors.lastname: Kang
authors.affiliation: Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Republic of Korea.
authors.forename: Sung Chan
authors.initials: SC
authors.lastname: Oh
authors.affiliation: Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 139-707, Republic of Korea.
authors.forename: Suk Jin
authors.initials: SJ
authors.lastname: Cho
mesh_terms: D021501:Flank Pain / Q000139:chemically induced*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007238:Infarction / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000009:adverse effects*; D010100:Oxygen / Q000627:therapeutic use; D011655:Pulmonary Embolism / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy; D011978:Receptors, Nicotinic; D016540:Smoking Cessation; D016896:Treatment Outcome; D000068580:Varenicline / Q000009:adverse effects*
chemical_list: D018722:Nicotinic Agonists; D011978:Receptors, Nicotinic; C403531:nicotinic receptor alpha4beta2; D006493:Heparin; D010100:Oxygen; D000068580:Varenicline
keywords: Adverse reaction; Pulmonary infarction; Pulmonary thromboembolism; Smoking cessation; Varenicline