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

Ticagrelor is a potent P2Y12 inhibitor that is increasingly used in acute coronary syndrome. Although drug-related 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.