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A strategy for addressing aspirin hypersensitivity in patients requiring urgent PCI

Patrick Schiano1, Philippe Gabriel Steg, Franck Barbou

  • 1Hôpital d'Instruction des Armées du Val de Grâce, Paris, France.

European Heart Journal. Acute Cardiovascular Care
|September 25, 2013
PubMed

Insights

For acute myocardial infarction patients allergic to aspirin, a strategy combining percutaneous coronary intervention with glycoprotein IIb/IIIa blockers and rapid oral desensitization offers a viable treatment path. This approach manages hypersensitivity while ensuring critical antiplatelet therapy.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Aspirin is crucial for acute myocardial infarction (AMI) management, especially with stent implantation.
  • Optimal treatment for aspirin-hypersensitive patients with ST-elevation AMI remains undefined.

Purpose of the Study:

  • To propose and outline a management strategy for aspirin-hypersensitive patients undergoing percutaneous coronary intervention for ST-elevation AMI.

Main Methods:

  • Percutaneous coronary intervention (PCI) with intravenous glycoprotein IIb/IIIa receptor blockers for antiplatelet therapy.
  • Rapid oral desensitization initiated in the hours following PCI, once the patient is clinically stable.

Main Results:

  • This strategy aims to provide effective antiplatelet coverage despite aspirin hypersensitivity.
  • Facilitates necessary intervention in a high-risk patient population.

Conclusions:

  • A combined approach of PCI, glycoprotein IIb/IIIa blockers, and rapid oral desensitization is a suggested management strategy for aspirin-hypersensitive patients with ST-elevation AMI.
  • This strategy addresses the challenge of treating these patients, enabling essential interventions and therapy.

Keywords:
Acute myocardial infarctionallergyaspirindesensitisation

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