Contract
ACETYLSALICYLIC ACID DESENSITIZATION IN PATIENTS WITH CORONARY ARTERY SYNDROME: LITERATURE REVIEW, RETROSPECTIVE ANALYSIS AND PATIENT FOLLOW-UP PROCEDURE IN AN ITALIAN CARDIOLOGICAL CENTER.
1 1 2 1 1 1 1
X. XXXXX , X. XXXX , X. XXXXXXX , X. XXXXXXX , X. XXXXXXXXXX , X. XXXXXXXXX , X. XXXXXX SALÈ .
1CENTRO CARDIOLOGICO MONZINO, SERVIZIO DI FARMACIA OSPEDALIERA, MILANO, ITALY.
2UNIVERSITÀ DEGLI STUDI XX XXXXX, XXXXX DI LAUREA IN FARMACIA, PAVIA, ITALY. CENTRO CARDIOLOGICO MONZINO
Xxx Xxxxx Xxxxx, 0 00000 XXXXXX Xxxxx
Mail: xxxxxxxx@xxxxxxxxxxxxxxxxxxx.xx
Figure 1. Mechanism of the acetylsalicylic acid desensitization procedure
Background and Importance
Hypersensitivity to the acetylic acid (ASA) occurs in a wide range of the population, both in healthy subjects and patients with coronary heart disease increasing the risk of ischemic events.
Desensitization protocols for the treatment of hypersensitivity to ASA consist in the administration of increasing doses of ASA at a set time in order to sensitize the patient to the active substance and initiate a chronic treatment.
Aim and Objectives
• The aim of the work is obtaining a systematic review of the literature concerning the existing desensitization protocols.
• The purpose is to conduct a descriptive analysis of the population and evaluate the effectiveness and safety of the protocol over the short and long term.
Materials and Methods
A retrospective analysis was conducted on a group of patients treated with Xxxxxxx’x protocol (1), an increasing oral administration of ASA to 100 mg in five and a half hours.
Results
The literature's review has shown the Xxxxxxx’x protocol has the greatest number of sample and the best efficacy and safety data.
The retrospective analysis allowed the evaluation of the group composed of 30 patients aged > 18 years, admitted to the center between January 2020 and April 2022, diagnosed with coronary artery syndrome.
Figure 2. Scheme of the Rossini desensitization protocol [1]
% Patients with ASA allergy
3,33%
13,33%
83,33%
Yes
Questionable
Never hired
% Patients assuming antiplatelet at discharge
4,55%
9,09%
9,09%
77,27%
ASA
Indobufen
D,L-lysine acetylsalicylate
Acetylsalicylic acid 500 mg
Figure 3. Percentage of patients with ASA allergy Figure 4. N° patients with previous manifestations of ASA allergy
Figure 5. Patients assuming antiplatelet at discharge Figure 6. Patients trated with ASA at FU
Conclusion and Relevance
The evidence suggests that the Xxxxxxx’x protocol is effective for a wide spectrum of patients. The hospital pharmacist in agreement with the cardiologist will evaluate the possibility to implement a solution-based formulation to treat more fragile patients, who present history of allergy to ASA, dysphagia or requiring interventional procedures.
References and/or Acknowledgements
[1] X. Xxxxxxx, et al, «Aspirin desensitization in patients with coronary artery disease: results of the multicenter ADAPTED registry» Circ Cardiovasc Interv, vol. 10, 2017
N° patients with previous manifestations of ASA allergy
Sincope Gastrointestinal manifestations
Edema Anaphylactic shock Respiratory manifestations
Cutaneous manifestations
0
5
10
% Patients trated with ASA at FU
40,00%
60,00%
Yes
No