Aspirin hypersensitivity: a practical guide for cardiologists

Area of Science:

• Cardiology
• Immunology
• Pharmacology

Background:

• Aspirin is a cornerstone of antithrombotic therapy for cardiovascular disease.
• It is mandatory in dual antiplatelet therapy after percutaneous coronary intervention and for prosthetic valve replacement.
• Aspirin hypersensitivity affects 0.6%-2.5% of the population, presenting diverse clinical manifestations.

Purpose of the Study:

• To review the epidemiology, pathophysiology, and clinical presentations of aspirin hypersensitivity.
• To outline management options for patients with aspirin hypersensitivity.
• To differentiate true aspirin allergy from intolerance and discuss desensitization protocols.

Main Methods:

• Literature review of epidemiology, pathophysiology, clinical presentations, and management of aspirin hypersensitivity.
• Characterization of aspirin allergy versus intolerance.
• Discussion of desensitization protocols.

Main Results:

• Aspirin hypersensitivity presents with a wide range of symptoms, from respiratory issues to anaphylaxis.
• Distinguishing true allergy from intolerance is critical for appropriate management.
• Desensitization protocols offer a viable option for patients requiring aspirin therapy.

Conclusions:

• Aspirin hypersensitivity poses a significant clinical challenge in cardiovascular medicine.
• Accurate diagnosis and tailored management, including desensitization, are essential to avoid omitting this vital medication.
• Further research into pathophysiological mechanisms can refine treatment strategies.