Aspirin Hypersensitivity Often Misdiagnosed in CVD Patients

Patients with cardiovascular disease are frequently categorized as allergic to aspirin when in fact they don’t have a true hypersensitivity to the medication—a mistake that likely deprives them from receiving this drug in the future, according to a new study.

“Aspirin is a highly cost-effective therapy,” said lead author Gabriela Orgeron, MD, cardiology post-doctoral fellow at Johns Hopkins Hospital, in Baltimore. “It is considered to be key in the management and prevention of patients with moderate to high risk for cardiovascular disease.”
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From an outpatient cardiology practice, the researchers reviewed the medical records of 5052 patients. They found 2.5% (n=131) had aspirin hypersensitivity, including skin reactions in 19% (n=26), angioedema in 3.0% (n=4), anaphylaxis in 0.7% (n=1), and respiratory symptoms in 0.7% (n=1). However, none of these patients were referred to an allergist for further management and possible desensitization.

A lack of knowledge about desensitization might be to blame, Orgeron said. “There are several desensitization protocols available for patients in the outpatient setting and also for those patients that may require emergent percutaneous coronary intervention.”

The study also revealed that 34.3% of patients were mistakenly labeled as having aspirin hypersensitivity if they had a history of gastrointestinal symptoms. In addition, with 39% of cases, no proper documentation existed for the type of aspirin reaction.

“Aspirin continues to be the anti-platelet agent of choice for those with cardiovascular disease due to its effectiveness, low cost, and few side effects,” the researchers concluded. “However, patients are frequently managed by discontinuing aspirin or are switched to another agent, when there is no supportive data to do so.”

Orgeron plans to continue her research in this area. She has completed a second project that looks at the management of aspirin hypersensitivity in patients undergoing percutaneous coronary intervention.

-Mike Bederka

Reference:

Orgeron G, Sekhsaria S. Prevalence and management of aspirin hypersensitivity in the outpatient cardiology practice. Paper presented at: ACAAI Annual Meeting, San Antonio, Texas. Nov. 5-9, 2015.