title: Aspirin challenge/desensitisation before coronary stenting in subjects with history of hypersensitivity. A pragmatic approach.
abstract: BACKGROUND
  Aspirin hypersensitivity may represent a major problem in patients with ischemic coronary disease who need a stenting procedure. In those patients, clinically unsettled reasonably quick desensitisation procedures are needed. In our study we attempted to select the most suitable procedure on the basis of characteristics and severity of ASA hypersensitivity.
  
  
  METHODS
  Thirty patients with a history of mild reactions to anti-inflammatory doses of aspirin (> 325 mg) were considered at low risk and underwent a tolerance test in 5 steps. Thirty-one patients, with a history of severe reactions to anti-platelet doses of aspirin 0 mg) underwent a slow desensitisation in 12 steps, reaching a cumulative dose of 150 mg ASA in 220 minutes.
  
  
  RESULTS
  In the first group, 29 patients tolerated the challenge. One developed urticaria, thus underwent challenge/desensitisation and achieved tolerance. In the second group, 3 patients did not tolerate the procedure and had to discontinue. CONCLUSION. Our approach to aspirin hypersensitivity in patients needing coronary stenting, based on a severity stratification, allowed to achieve an effective tolerance to aspirin in the majority of subject in a reasonable short time.
authors.affiliation: Internal Medicine and Rheumatology Unit, Rimini Hospital, Rimini, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cortellini
authors.forename: S
authors.initials: S
authors.lastname: Testi
authors.forename: M
authors.initials: M
authors.lastname: Severino
authors.forename: T
authors.initials: T
authors.lastname: Chechi
authors.forename: M L
authors.initials: ML
authors.lastname: Iorno
authors.forename: A
authors.initials: A
authors.lastname: Santucci
authors.forename: A
authors.initials: A
authors.lastname: Corvetta
authors.forename: G
authors.initials: G
authors.lastname: Piovaccari
authors.forename: A
authors.initials: A
authors.lastname: Santarelli
authors.forename: N
authors.initials: N
authors.lastname: Franco
authors.forename: G W
authors.initials: GW
authors.lastname: Canonica
authors.forename: G
authors.initials: G
authors.lastname: Passalacqua
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000009:adverse effects*; D003888:Desensitization, Immunologic / Q000379:methods*; D004342:Drug Hypersensitivity / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D015607:Stents
chemical_list: D001241:Aspirin