动脉样性心血管疾病患者的阿司匹林过敏症
Mattia Galli1, Gabriele Cortellini2, Giovanni Occhipinti3
1Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
Journal of the American College of Cardiology
|October 23, 2024
概括
阿司匹林过敏会影响到1%至5%的心血管疾病患者. 脱敏和阿司匹林挑战是安全的,有效的替代品,但未被充分利用,造成管理困境.
科学领域:
- 心脏病学 心脏病学
- 临床免疫学临床免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 低剂量阿司匹林是动脉样硬化心血管疾病 (ASCVD) 的基石抗血小板疗法.
- 阿司匹林过敏会影响1%-5%的患者,使ASCVD管理复杂化,并且经常被误诊为不耐受性.
- 由于对阿司匹林过敏患者缺乏明确的指导方针,因此需要采取替代策略.
研究的目的:
- 为了澄清阿司匹林过敏和不耐受之间的区别.
- 讨论有效的管理策略,包括阿司匹林脱敏和挑战,对于需要阿司匹林治疗的ASCVD患者.
- 为管理ASCVD中阿司匹林过敏症提供实用算法.
主要方法:
- 对病理生理机制的审查和阿司匹林过敏症的分类.
- 分析关于阿司匹林脱敏和阿司匹林挑战协议的现有文献.
- 讨论替代抗血小板剂和临床管理算法.
主要成果:
- 阿司匹林脱敏和低剂量阿司匹林挑战是务实的,安全的,有效的管理阿司匹林过敏在ASCVD患者.
- 这些方法在临床实践中被系统地使用不足.
- 关于适当的替代抗血小板疗法,人们仍然感到困惑.
结论:
- 区分阿司匹林过敏症和不耐受症对于适当的患者管理至关重要.
- 阿司匹林脱敏和挑战为ASCVD患者提供可行的解决方案,尽管过敏,但需要阿司匹林治疗.
- 需要进一步的教育和标准化协议的实施,以改善这些患者的护理.
相关概念视频
01:26Atherosclerosis III: Management
1
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
1
01:27Atherosclerosis II: Clinical manifestations and prevention
1
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
1
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
478
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
478
01:27Peripheral Artery Disease III: Interprofessional Care
2
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
2
01:23Atherosclerosis IV: Nursing Management
1
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
1
01:19Acute Coronary Syndrome II: Pathophysiology and clinical manifestations
3
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
3