Aspirin hypersensitivity in patients with coronary artery disease: linking pathophysiology to clinical practice - 06/09/18
Abstract |
Dual antiplatelet therapy, consisting of aspirin and a P2Y12 receptor antagonist, has been the cornerstone of management in those undergoing percutaneous coronary intervention, reducing stent thromboses and cardiovascular events. Given the pivotal role of aspirin in cardiovascular disease management, patients with aspirin hypersensitivity pose complex clinical challenges. Allergy to aspirin is reported in 1.5-2.6% of patients presenting with cardiac disease. Identification of the subtype of aspirin hypersensitivity will determine suitability for aspirin desensitization, dictate choice of desensitization protocol and inform risk management. Aspirin desensitization is an effective and viable clinical strategy, although it remains underutilised in clinical practice. Collaboration between cardiologists and immunologists should be strongly encouraged to facilitate optimal management of such patients. This review describes the complexity of managing patients with aspirin hypersensitivity in cardiac disease, the indications and risks of aspirin desensitization, and the approach to management of the minority of patients who are unsuitable for desensitization.
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| Conflicts of interest: We do not have any financial or other interests to disclose. |
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| Funding: No extramural funding was used to support this work. |
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| The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence to permit this article (if accepted) to be published. |
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| All authors have read and approved this manuscript. All authors contributed to the paper. Sonali. R. Gnanenthiran was involved in the planning, literature review and writing of the manuscript. John Yiannikas was involved in the planning and writing of the manuscript. Harry. C. Lowe was involved in the writing of the manuscript. David. Brieger was involved in the writing of the manuscript. Sandhya Limaye was involved in the planning, literature review and writing of the manuscript. The authors are solely responsible for the design of this paper, all study analyses, the drafting and editing of the paper and its final contents. |
Vol 203
P. 74-81 - septembre 2018 Retour au numéro
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