Diffuse alveolar hemorrhage associated with ticagrelor therapy after percutaneous coronary intervention

After acute coronary syndrome (ACS), various antiplatelet agents are used to prevent stent thrombosis, death, and recurrent myocardial infarction. The currently available antiplatelet agents are clopidogrel, prasugrel, and ticagrelor. The European Society of Cardiology guidelines recommend ticagrelor as a first choice antiplatelet regimen after ACS (1). Diffuse alveolar hemorrhage (DAH) is a very rare complication, but combined with hemoptysis, diffuse lung infiltration, and acute respiratory failure, it will be a life-threatening one. Ticagrelor and prasugrel have a faster onset and more significant platelet inhibition than clopidogrel. Although dyspnea is frequently reported in patients receiving ticagrelor, DAH due to ticagrelor use is very rare in the literature (2, 3). Thus, we present two cases of antiplatelet-related DAH occurring after ticagrelor therapy