Spontaneous intermuscular hematoma in a patient receiving ticagrelor and aspirin: A case report

Abstract

Dual antiplatelet therapy is a cornerstone treatment following percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Ticagrelor, a direct-acting potent P2Y12 inhibitor, is superior to clopidogrel in the acute setting of ACS: due to its faster onset and potent antiplatelet inhibi-tion. Thus, ticagrelor is becoming widely recommended as the as the initial treatment following PCI in current guidelines. However, due to its potency, the risk of bleeding is higher. Herein, a report of an unusual case of spontaneous intermus-cular hematoma is described. Furthermore, single-nucleotide polymorphisms that may be related to bleeding in ticagrelor using population-based genome-wide association studies were also identified and are discussed. As there is a concern that patients of Asian origin may have a higher risk of bleeding, physicians must be made aware of this risk when prescribing ticagrelor to individuals of Asian decent.