Safety of Aspirin Desensitization in Patients With Reported Aspirin Allergy and Cardiovascular Disease
Article first published online: 18 SEP 2012
© 2012 Wiley Periodicals, Inc.
Volume 36, Issue 1, pages 25–30, January 2013
How to Cite
McMullan, K. L. and Wedner, H. J. (2013), Safety of Aspirin Desensitization in Patients With Reported Aspirin Allergy and Cardiovascular Disease. Clin Cardiol, 36: 25–30. doi: 10.1002/clc.22054
- Issue published online: 11 JAN 2013
- Article first published online: 18 SEP 2012
- Manuscript Accepted: 1 AUG 2012
- Manuscript Received: 4 JUN 2012
Aspirin (ASA) is the drug of choice in patients with coronary artery disease for primary and secondary prevention. This poses a problem for those patients reporting hypersensitivity to this drug or class of drugs.
Desensitization to ASA may be carried out safely and effectively in patients with reported ASA or nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity needing ASA for cardiac indications. Our 7-step protocol is one choice for a rapid desensitization protocol.
A retrospective chart review was conducted evaluating ASA desensitization in patients with reported ASA or NSAID hypersensitivity and a cardiac indication for ASA.
In 160 evaluations over 15 years, 89 desensitizations were performed in both the inpatient and outpatient setting with only 16 reactions (18%). Eleven of these 16 patients (68.7%) were able to take daily ASA. Twenty-six desensitization procedures were performed with our 7-step rapid desensitization protocol in 10 inpatients and 16 outpatients with 3 reactions (18.75% of reactions). Initial reaction to ASA involving angioedema and reacting to ASA within the past year increased the risk of having a reaction to desensitization.
Desensitization may be safely performed in patients with reported ASA or NSAID hypersensitivity and a cardiac indication for ASA. Our 7-step rapid protocol may be used in both the inpatient and outpatient setting to desensitize these patients. Patients who had angioedema with ASA ingestion or a reaction to ASA within the past year are at higher risk for reaction during the desensitization protocol.
The authors have no funding, financial relationships, or conflicts of interest to disclose.