Ticagrelor Induced Upper Gastrointestinal Bleeding: A Case Report

Upper gastrointestinal bleeding is a common reason for hospitalisation in the elderly, and it has a high morbidity and mortality rate if not managed properly.Upper GI bleeding is caused by variables such as advanced age, H. pylori infection, drug use, cigarette smoking, and liver disease.Lowering the usage of aspirin and NSAIDs, as well as co-prescribing PPIs in patients initiating long-term NSAID therapy, are all controllable risk factors for upper GI bleeding.Upper GI bleeding is frequently caused by peptic ulcer disease, which is followed by erosive gastroesophagitis, gastroesophageal varices, Mallory-Weiss tears, Dieulafoy's lesions, gastric antral vascular ectasia (GAVE), and portal hypertensive gastropathy.The ESC advises stopping DAPT and continuing with SAPT, preferably with P2Y12 inhibitors, especially in GI bleeding.A 60-year-old male patient with intermittent melena and widespread weakness was diagnosed with antral and gastroduodenal ulcers, which caused upper GI hemorrhage.The guidelines suggest starting OAC again after a week, using the lowest acceptable target INR or the lowest effective dose.Aspirin should be continued until the P2Y12 inhibitor is discontinued for a maximum of 7 days in patients receiving DAPT.