Diffuse alveolar hemorrhage associated with ticagrelor therapy after percutaneous coronary intervention

Yılmaz, Samet; Kilic, Oguz; Yaylali, Yalın Tolga

doi:10.14744/anatoljcardiol.2018.47776

Cited by 3 publications

(4 citation statements)

References 4 publications

(8 reference statements)

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“… 49 , 50 However, P2Y12 inhibitors could aggregate DAH according to published literatures. 51 Results from large randomized controlled trials provide evidence supports a net benefit of aspirin-free strategies (reduce aspirin duration to 1-3 months) after PCI for patients at low, intermediate, and high risk for both ischemia and bleeding. 52 Zhou et al suggested among patients with COVID-19 who are currently on DAPT, maintaining P2Y12 inhibitor monotherapy (preferably ticagrelor) may be scientifically reasonable for patients with PCI performed ≥3 months.…”

Section: Treatmentmentioning

confidence: 93%

Cardiovascular manifestation and treatment in COVID-19

Kuo

Lin

et al. 2020

Journal of the Chinese Medical Association

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The novel coronavirus disease 2019 (COVID-19), with first presentation of atypical pneumonia, has spread rapidly from Wuhan, China, on December 12, 2019 to over 200 countries, caused 2 310 572 infected individuals and 158 691 mortalities, updated on April 19, 2020. Many studies have published timely to help global healthcare workers to understand and control the disease. Vulnerable patients with risk factors such as elderly, cardiovascular diseases (eg, hypertension, coronary disease, or cardiomyopathy), diabetes, and chronic kidney disease have worse outcomes after COVID-19 infection. COVID-19 could directly cause cardiovascular injuries such as pericarditis, myocarditis, myocardial infarction, heart failure, arrhythmias, or thromboembolic events, which urge cardiologists to be involved in the frontline to practice. Here, we provide a review of COVID-19 on cardiovascular system to assist clinical cardiologists to better understand the disease and being capable of providing comprehensive medical support.

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Section: Treatmentmentioning

confidence: 93%

Cardiovascular manifestation and treatment in COVID-19

Kuo

Lin

et al. 2020

Journal of the Chinese Medical Association

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“…There are only limited case reports in the literature concerning pulmonary hemorrhage or diffuse alveolar hemorrhage (DAH) during ticagrelor treatment [5][6][7][8] . In our case, the patient was heavily bleeding in both the bronchoscopies conducted, being even hemodynamically unstable in the second one, and diagnostic approach through BAL was not feasible in either case.…”

Section: Discussionmentioning

confidence: 99%

“…A remarkable point of interest in this case report is the time interval between initiation of DAT treatment and the onset of pulmonary hemorrhage. In previous case reports [5][6][7][8] , the time interval is limited to a few hours to 14 days duration of ticagrelor treatment and only Grondahl et al 16 have reported a case of a patient with DAH 10 years after initiation of dual antiplatelet therapy with ASA and prasugrel (an irreversible antagonist of P2Y12 ADP receptor). Since ticagrelor use is rising in recent years, clinicians should be able to recognize this potential adverse event even in the setting of its long-term use.…”

Section: Discussionmentioning

confidence: 99%

A life-threatening massive hemoptysis case in the course of dual antiplatelet therapy with ticagrelor

Molyvas¹,

Kipourou²,

Lampridis³

et al. 2022

Pneumon

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Massive hemoptysis is a life-threatening medical condition which usually occurs in the course of parenchymal destructive diseases. We herein report the case of a 61-year-old male patient who presented with massive hemoptysis six months after commencement of dual antiplatelet therapy with acetylsalicylic acid and ticagrelor, for drug-eluting coronary stents. Control of bleeding with discontinuation of both antiplatelet agents, as well as negative imaging and laboratory studies for other pulmonary hemorrhage causes, indicate that either of the antiplatelet drugs or combination thereof was the cause of the pulmonary hemorrhage. In contrast to the previous limited case reports with pulmonary hemorrhage early during antiplatelet therapy with ticagrelor, this case highlights that it can even occur later in the course of antiplatelet therapy.

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“…Intraparenchymal hepatic hemorrhages are generally seen secondary to severe trauma; on the other hand, rarely can they also be seen due to used anticoagulant treatment, pregnancy and iatrogenic reasons [ 2 - 4 ]. In the literature review, although diffuse alveolar hemorrhage developed in the lung secondary to ticagrelor has been observed, no intraparenchymal hepatic hemorrhage case due to ticagrelor use was found without trauma [ 5 ]. With this case, we aimed to present this rare bleeding complication due to the use of ticagrelor and to discuss the early de-escalation process to clopidogrel therapy in elderly patients.…”

Section: Introductionmentioning

confidence: 99%

A Case of Intraparenchymal Hepatic Hemorrhage Due to Ticagrelor Loading Treatment in an Elderly Patient With Acute Coronary Syndrome

Kaynak¹,

Aslan²

2021

Cureus

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Ticagrelor is a potent P2Y12 inhibitor that is increasingly used in acute coronary syndrome. Although drugrelated intrahepatic hemorrhages have been reported with anticoagulant drugs, no case of intrahepatic hemorrhage due to ticagrelor has been encountered in the literature. With this case, we tried to explain that potent antiaggregant drugs may cause this rare bleeding complication. Although ticagrelor is used for rapid antiaggregation effect in acute coronary syndrome, de-escalation to clopidogrel treatment in elderly patients during the hospitalization period is a more reasonable option.

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Diffuse alveolar hemorrhage associated with ticagrelor therapy after percutaneous coronary intervention

Cited by 3 publications

References 4 publications

Cardiovascular manifestation and treatment in COVID-19

Cardiovascular manifestation and treatment in COVID-19

A life-threatening massive hemoptysis case in the course of dual antiplatelet therapy with ticagrelor

A Case of Intraparenchymal Hepatic Hemorrhage Due to Ticagrelor Loading Treatment in an Elderly Patient With Acute Coronary Syndrome

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