Rapid desensitisation

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Hellenic J Cardiol. 2011 Jul-Aug;52(4):307-10.Rapid desensitisation of patients with aspirin allergy who undergo coronary angioplasty.Christou A, Kafkas N, Marinakos A, Katsanos S, Papanikitas K, Patsilinakos S.SourceCardiology Department, Konstantopoulio General Hospital, Nea Ionia, Athens, Greece.AbstractINTRODUCTION:Although aspirin is the cornerstone of medication in patients with coronary artery disease, a minority of these patients have aspirin sensitivity. The aim of this study was to evaluate the efficacy and safety of an aspirin desensitisation protocol in patients scheduled for coronary angioplasty and stenting.METHODS:We used a challenge-desensitisation protocol in 11 patients (6 men, mean age 56 ± 9.6 years) who reported allergy to aspirin and were to undergo percutaneous coronary intervention with stent implantation. Eight had a history of cutaneous sensitivity, 1 had rhinitis, 1 reported urticaria and rhinitis, while another patient showed a respiratory response in the form of an asthma attack after taking aspirin in the past. Eight successive doses of aspirin were given (0.1, 0.3, 10, 30, 40, 81, 162, 325 mg) at intervals of 15-25 min over a total period of 2 h 15 min.RESULTS:All patients with aspirin sensitivity completed the desensitisation therapy successfully, without adverse effects, and subsequently underwent angioplasty and stenting. During follow up, the patients continued to take aspirin over 6-19 months without any problems.CONCLUSIONS:Rapid aspirin desensitisation is an effective and safe procedure for patients with aspirin allergy who are to undergo coronary angioplasty and stenting, allowing them to receive the optimum treatment.