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

Diffuse alveolar hemorrhage after percutaneous coronary intervention is a rare complication that has been mostly reported in association with glycoprotein IIb/IIIa inhibitors. We herein report a case of a 64-year-old male who developed a diffuse pulmonary hemorrhage after coronary stent implantation for ST-elevation myocardial infarction. Diagnostic bronchoscopy determined the hemorrhage to be a bland pulmonary hemorrhage, and this pattern suggested that combination therapy with aspirin and ticlopidine was therefore the most likely cause. The combination of aspirin and thienopyridine agents is a routine therapeutic protocol for patients after coronary stent implantation. Therefore, physicians should be aware that this dual antiplatelet therapy might sometimes induce fatal complications.