title: Aspirin desensitization in patients undergoing percutaneous coronary intervention: a survey of current practice.
abstract: BACKGROUND
  Aspirin remains the mainstay of anti-platelet therapy in cardiac patients. However, if a patient is allergic to aspirin and dual anti-platelet therapy is indicated - such as with percutaneous coronary intervention (PCI), then there is no clear guidance. One possibility is aspirin desensitization. A variety of protocols exist for the rapid desensitization of patients with aspirin allergy. The aim of this survey was to assess current knowledge and practice regarding aspirin desensitization in the UK.
  
  
  RESULTS
  We conducted a UK wide survey of all UK 116 PCI centers and obtained complete responses from 40 (35.4%) centers. Of these, just 7 (17.5%) centers had previously desensitised patients; 29 (87.9%) centers suggested a lack of a local protocol prevented them from desensitizing, with 10 (30.3%) unsure of how to conduct desensitization. Only 5 (12.5%) centers had a local policy for aspirin desensitization although 25 (64.1%) units had a clinical strategy for dealing with aspirin allergy; the majority (72%) giving higher doses of thienopyridine class drugs.
  
  
  CONCLUSIONS
  In the UK, there appears to be no consistent approach to patients with aspirin allergy. Patients undergoing PCI benefit from dual anti-platelet therapy (including aspirin), and aspirin desensitization in those with known allergy may facilitate this. Sustained effort should be placed on encouraging UK centers to use desensitization as a treatment modality prior to PCI rather than avoiding aspirin altogether.
authors.affiliation: Cardiac Unit, Raigmore Hospital, Inverness, Great Britain. stephen.leslie@nhs.net.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Chapman
authors.forename: Gordon F
authors.initials: GF
authors.lastname: Rushworth
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Leslie
mesh_terms: D001241:Aspirin / Q000009:adverse effects*; D003888:Desensitization, Immunologic / Q000592:standards / Q000639:trends*; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D019538:Health Care Surveys; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends*; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin