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Aspirin desensitization for cardiovascular disease
1Scripps Clinic Medical Group, San Diego, California, USA.
Current Opinion in Allergy and Clinical Immunology
|June 26, 2015
Summary
Patients with aspirin hypersensitivity can often safely take aspirin for cardiovascular disease through desensitization protocols. This approach is crucial for managing patients with a history of aspirin or NSAID allergies.
Area of Science:
- Cardiology
- Allergology
- Pharmacology
Background:
- Aspirin (acetylsalicylic acid; ASA) is vital in managing coronary artery disease.
- A significant unmet need exists for patients with aspirin hypersensitivity or nonsteroidal anti-inflammatory drug (NSAID) allergies requiring antiplatelet therapy.
- Aspirin hypersensitivity is reported in 1.5% of patients with cardiovascular disease.
Purpose of the Study:
- To review aspirin hypersensitivity in patients with cardiovascular disease.
- To address the need for safe aspirin therapy in patients with a history of aspirin or NSAID hypersensitivity.
- To provide a rational approach to oral aspirin challenge and desensitization.
Main Methods:
- Review of existing literature on aspirin hypersensitivity and desensitization protocols.
- Identification of different types of aspirin reactions.
- Evaluation of oral aspirin challenge and desensitization strategies.
Main Results:
- Many patients labeled as aspirin-allergic tolerate aspirin safely after evaluation, having experienced side-effects rather than true hypersensitivity.
- True aspirin hypersensitivity necessitates careful management to ensure appropriate antiplatelet therapy.
- Various desensitization protocols exist, ranging in complexity.
Conclusions:
- Most patients with a history of 'aspirin/NSAID allergy' can safely receive aspirin for cardiovascular indications via graded challenge or desensitization.
- Allergists play a central role in managing these patients.
- Safe aspirin administration is achievable, ensuring cardiovascular protection.
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