Association Between Kounis Syndrome and Allergy-Associated Coronary Events: A Disproportionality Analysis Using the...

Area of Science:

• Cardiology
• Allergy
• Pharmacovigilance

Background:

• Kounis syndrome (KS) is an allergy-induced acute coronary syndrome (ACS).
• Underdiagnosis of KS is a concern due to a lack of clear diagnostic criteria.
• Misclassification can lead to inappropriate treatment and risk stratification.

Purpose of the Study:

• To differentiate clinical characteristics between KS and non-KS allergy-associated coronary events.
• To improve diagnostic recognition and clinical awareness of Kounis syndrome.
• To identify predictors for non-KS events.

Main Methods:

• Utilized the Japanese Adverse Drug Event Report database (2012Q3-2024Q2).
• Compared patient demographics, suspected drugs, and clinical features between KS (n=130) and non-KS (n=115) groups.
• Performed multivariate analysis to identify predictors of non-KS events.

Main Results:

• KS group associated with anesthetics and contrast media; non-KS group with heparin and COVID-19 vaccine.
• The non-KS group exhibited higher mortality and more specific underlying diseases.
• Independent predictors for non-KS events included heparin-induced thrombocytopenia, antineoplastic drug use, fatal outcomes, shock, and ACS.

Conclusions:

• Patients without KS diagnosis often present with severe conditions and poorer outcomes.
• This suggests potential underdiagnosis or oversight of Kounis syndrome in clinical practice.
• Findings emphasize the need for improved KS diagnostic clarity and pharmacovigilance.