Diffuse alveolar hemorrhage as a complication of dual antiplatelet therapy for acute coronary syndrome

Ikeda, Masataka; Tanaka, Haruki; Sadamatsu, Kenji

doi:10.1016/j.carrev.2011.03.003

Cited by 19 publications

(11 citation statements)

References 15 publications

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“…Kilaru et al10) reported the first case of diffuse alveolar hemorrhage developing after clopidogrel therapy given for placement of a coronary stent. Recently, Ikeda et al11) reported a case of diffuse pulmonary hemorrhage developing after combination therapy with aspirin and ticlopidine following coronary stent implantation for ST elevation myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Alveolar Hemorrhage after Clopidogrel Use for ST Elevation Myocardial Infarction

Kim

Lim

et al. 2013

Korean Circ J

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Combination treatment of antiplatelet drugs containing aspirin and clopidogrel reduces systemic ischemic events after percutaneous coronary intervention (PCI) in high risk patients. However, this combination treatment of antiplatelet drugs is associated with increased risk of nonfatal and fatal bleeding. Diffuse alveolar hemorrhage after PCI is a rare complication that has been mostly reported in association with glycoprotein IIb/IIIa inhibitors. We report the case of a 62-year-old man who presented with ST elevation myocardial infarction and suffered a diffuse alveolar hemorrhage after clopidogrel use following primary PCI.

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Section: Discussionmentioning

confidence: 99%

Pulmonary Alveolar Hemorrhage after Clopidogrel Use for ST Elevation Myocardial Infarction

Kim

Lim

et al. 2013

Korean Circ J

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“…Other causes of pulmonary alveolar hemorrhage include acute respiratory distress syndrome, pulmonary renal syndrome, idiopathic pulmonary capillaritis and connective tissue diseases 5. Ikeda et al6 reported a case in which alveolar hemorrhage occurred following dual anti-platelet therapy. Clinically, pulmonary alveolar hemorrhage presents as a triad of hemoptysis, diffuse alveolar opacities in chest radiography and anemia.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary alveolar hemorrhage following thrombolytic therapy

Narayanan¹,

Thulaseedharan²,

Subramaniam

et al. 2017

IMCRJ

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We report a case of a 58-year-old male without any comorbidities who was thrombolysed with streptokinase for acute anterior wall myocardial infarction and developed massive hemoptysis with dyspnea and imaging features showing bilateral alveolar infiltrates. He was diagnosed with pulmonary alveolar hemorrhage and treated conservatively. His condition improved, and follow-up imaging showed resolution. Alveolar hemorrhage is a rare and life-threatening complication of thrombolytic therapy.

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“…Only 10 of the 5.382 patients (0.19%) who received abciximab in 4 clinical trials developed pulmonary haemorrhage (6) . Ikeda et al reported a case of a patient who developed DAH after coronary stent implantation for STEMI due to aspirin and ticlopidine therapy (7) . Kilaru et al reported the first case of a patient who developed DAH after the placement of a coronary stent due to clopidogrel therapy (8) .…”

Section: Discussionmentioning

confidence: 99%

Diffuse Alveolar Haemorrhage Due to Clopidogrel Use in a Patient Who Had Undergone Primary Percutaneous Intervention

Kaya¹

2017

Kosuyolu Heart Journal

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Anti-thrombotic drugs are inevitable and represent the most suitable drug therapy for patients presenting with stable angina pectoris and acute coronary syndromes [unstable angina pectoris, non-ST segment elevation myocardial infarction (NSTEMI) and STEMI]. Anti-platelet and anti-coagulant drugs have reduced the incidence of death and transmural myocardial infarction in patients with acute coronary syndromes (ACSs). Besides their favourable effect in terms of inhibiting thrombus formation, they increase the risk of bleeding by inhibiting platelets in ACS by the same mechanism. Here we present a case of a patient who was admitted to our institution with chest pain and who was diagnosed with anterior myocardial infarction. After initiating anti-platelet therapy with 300 mg acetylsalicylic acid orally and 600 mg clopidogrel orally, the patient underwent primary percutaneous coronary intervention, which ended with predilatation and stent implantation of the left anterior descending artery (LAD). After 2 hours of clopidogrel ingestion, the patient presented with bloody sputum and dyspnoea in the coronary care unit just after the intervention. Thoracic high-resonance computed tomography (HRCT) revealed diffuse alveolar haemorrhage, and clopidogrel was stopped. Diffuse alveolar haemorrhage due to clopidogrel is a very rare major complication, and considering how commonly clopidogrel is used, diagnosis and management of this complication are crucial. Key Words: Acute anterior myocardial infarction; clopidogrel use; diffuse alveolar haemorrhage; complication Primer Perkütan Koroner İşlem Sonrasında Klopidogrel Kullanımına Bağlı Difüz Alveoler Hemoraji ÖZETAntitrombotik ilaçlar stabil anjina pektoris ve akut koroner sendrom (kararsız angina pektoris, ST segment yükselmesiz miyokart infarktüsü, ST segment yükselmeli miyokart infarktüsü) ile başvuran hastalar için olmazsa olmaz ve en uygun ilaç tedavisidir. Antiplatelet ve antikoagülan ilaçlar, akut koroner sendromda ölüm ve transmural miyokart infarktüsü insidansını azalttı. Bu ilaçların trombüs oluşumunu engelleme ve trombositleri inhibe etme mekanizması ile benzer şekilde kanama riskini artırırlar. Burada göğüs ağrısı ile kliniğimize başvuran ve anterior miyokart infarktüsü tanısı konulan bir olgu sunulmuştur. Hastaya rutin klopidogrel 600 mg ve asetilsalisilik asit 300 mg oral başlandıktan sonra sol ön inen arter (LAD)'e predilatasyon ve stent implantasyonu uygulandı. Klopidogrel alınmasından iki saat sonra koroner yoğun bakım ünitesindeki takibinde kanlı balgam ve nefes darlığı gelişti. Toraks yüksek rezonans bilgisayarlı tomografide difüz alveoler hemoraji saptandı ve klopidogrel kesildi. Klopidogrele bağlı difüz alveoler hemoraji çok nadir görülen bir komplikasyon olmakla birlikte bu ilacın ne kadar sıklıkta kullanıldığı düşünülürse tanı ve tedavinin önemi ortaya çıkar.

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Diffuse alveolar hemorrhage as a complication of dual antiplatelet therapy for acute coronary syndrome

Cited by 19 publications

References 15 publications

Pulmonary Alveolar Hemorrhage after Clopidogrel Use for ST Elevation Myocardial Infarction

Pulmonary Alveolar Hemorrhage after Clopidogrel Use for ST Elevation Myocardial Infarction

Pulmonary alveolar hemorrhage following thrombolytic therapy

Diffuse Alveolar Haemorrhage Due to Clopidogrel Use in a Patient Who Had Undergone Primary Percutaneous Intervention

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