Prevalence and management of aspirin hypersensitivity in a cardiology practice.
Prevalence and management of aspirin hypersensitivity in a cardiology practice.
- 2020
Background: Data are lacking with concern to the prevalence and management of aspirin (ASA) hypersensitivity. Objective: To study the prevalence, different types of reactions, and implications for clinical management of ASA hypersensitivity in a cardiology practice. Methods: We conducted an electronic medical record review of 11,375 individuals, 5052 (44%) in the ambulatory setting, and 6323 (56%) admitted for percutaneous coronary intervention (PCI), from January 2012 to December 2013. Results: The prevalence of ASA hypersensitivity was 1.88% (n = 214). Skin reactions were the most common (40 [19%]), followed by angioedema (10 [4.6%]), respiratory (9 [4.2%]), and anaphylaxis (6 [2.8%]). No records were found for 74 patients (34.5%), and 69 patients (32.2%) were mistakenly labeled as allergic for having gastrointestinal symptoms. Of the 214 patients who had documented ASA hypersensitivity, 108 individuals (50.46%) had coronary artery disease. The medications at discharge were the following: ASA (30 [14%]), thienopyridine (48 [22%]), a combination of ASA and thienopyridine (13 [6%]), anticoagulation only (26 [12%]), and no antiplatelet (97 [43%]). Conclusion: ASA hypersensitivity is often not documented correctly or is often misdiagnosed or not appropriately managed. There is a need for improved management of ASA hypersensitivity, including appropriate referral for ASA desensitization and combating unnecessary avoidance in patients with intolerance due to adverse effects.
English
1088-5412
10.2500/aap.2020.41.190032 [doi]
*Allergens/ae [Adverse Effects]
*Aspirin/ae [Adverse Effects]
*Coronary Disease/ep [Epidemiology]
*Drug Hypersensitivity/ep [Epidemiology]
*Percutaneous Coronary Intervention
Adult
Aged
Aged, 80 and over
Allergens/im [Immunology]
Aspirin/tu [Therapeutic Use]
Coronary Disease/di [Diagnosis]
Diagnostic Errors/pc [Prevention & Control]
Drug Hypersensitivity/di [Diagnosis]
Electronic Health Records
Female
Humans
Male
Middle Aged
Prevalence
Retrospective Studies
United States/ep [Epidemiology]
Young Adult
MedStar Union Memorial Hospital
Journal Article
Research Support, Non-U.S. Gov't
Background: Data are lacking with concern to the prevalence and management of aspirin (ASA) hypersensitivity. Objective: To study the prevalence, different types of reactions, and implications for clinical management of ASA hypersensitivity in a cardiology practice. Methods: We conducted an electronic medical record review of 11,375 individuals, 5052 (44%) in the ambulatory setting, and 6323 (56%) admitted for percutaneous coronary intervention (PCI), from January 2012 to December 2013. Results: The prevalence of ASA hypersensitivity was 1.88% (n = 214). Skin reactions were the most common (40 [19%]), followed by angioedema (10 [4.6%]), respiratory (9 [4.2%]), and anaphylaxis (6 [2.8%]). No records were found for 74 patients (34.5%), and 69 patients (32.2%) were mistakenly labeled as allergic for having gastrointestinal symptoms. Of the 214 patients who had documented ASA hypersensitivity, 108 individuals (50.46%) had coronary artery disease. The medications at discharge were the following: ASA (30 [14%]), thienopyridine (48 [22%]), a combination of ASA and thienopyridine (13 [6%]), anticoagulation only (26 [12%]), and no antiplatelet (97 [43%]). Conclusion: ASA hypersensitivity is often not documented correctly or is often misdiagnosed or not appropriately managed. There is a need for improved management of ASA hypersensitivity, including appropriate referral for ASA desensitization and combating unnecessary avoidance in patients with intolerance due to adverse effects.
English
1088-5412
10.2500/aap.2020.41.190032 [doi]
*Allergens/ae [Adverse Effects]
*Aspirin/ae [Adverse Effects]
*Coronary Disease/ep [Epidemiology]
*Drug Hypersensitivity/ep [Epidemiology]
*Percutaneous Coronary Intervention
Adult
Aged
Aged, 80 and over
Allergens/im [Immunology]
Aspirin/tu [Therapeutic Use]
Coronary Disease/di [Diagnosis]
Diagnostic Errors/pc [Prevention & Control]
Drug Hypersensitivity/di [Diagnosis]
Electronic Health Records
Female
Humans
Male
Middle Aged
Prevalence
Retrospective Studies
United States/ep [Epidemiology]
Young Adult
MedStar Union Memorial Hospital
Journal Article
Research Support, Non-U.S. Gov't