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Kounis Syndrome Features in Special Populations
Alexandr Ceasovschih1, Nicholas G Kounis2, Sura Markos3
1Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Medical Sciences (Basel, Switzerland)
|May 27, 2026
Summary
Kounis syndrome links allergic reactions to heart attacks. This review explores how age, health conditions, and immune status affect Kounis syndrome presentation and outcomes in diverse patient groups.
Area of Science:
- Cardiology
- Immunology
- Allergy
Background:
- Kounis syndrome (KS) involves acute coronary syndromes triggered by hypersensitivity reactions.
- Its prevalence is underestimated due to diagnostic challenges and low awareness.
Purpose of the Study:
- To review Kounis syndrome in special populations.
- To highlight how patient factors modify KS presentation, diagnosis, and outcomes.
Main Methods:
- Narrative review of existing literature.
- Focus on age, comorbidities, immune status, and vascular factors.
Main Results:
- Elderly: Polypharmacy and plaque vulnerability favor Type II/III KS.
- Pediatric: Predominantly Type I, linked to allergies, stings, vaccines, antibiotics.
- Special populations (stents, CKD, pregnancy, atopy, COVID-19) show modified KS risk and presentation.
Conclusions:
- A host-modified framework integrating immune phenotype and vascular substrate is proposed.
- This framework can improve risk stratification and personalize prevention for Kounis syndrome.
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