Perkowska Jolanta, Kruszewski Jerzy, Kłos Krzysztof, Kramarz Elżbieta
Department of Infectious Diseases and Allergology, Military Institute of Medicine, Warsaw, Poland.
Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.
Postepy Dermatol Alergol. 2020 Aug;37(4):579-583. doi: 10.5114/ada.2019.88623. Epub 2019 Oct 14.
It is known that the administration of the drug during the oral aspirin challenge (OAC) can cause hypersensitivity symptoms not only from the respiratory system or skin, but also from the cardiovascular system.
To assess the occurrence and nature of cardiovascular adverse events during the OAC in patients suspected of hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs).
The study included 52 patients with symptoms of hypersensitivity to aspirin (ASA) or other NSAIDs in the form of skin reactions or respiratory response in anamnesis. Patients were treated with OAC and simultaneously were subject to monitoring of clinical manifestations of hypersensitivity to ASA/NSAIDs, ventilation disorders and cardiovascular functions.
The most common reaction of the cardiovascular system during OAC was tachycardia or supraventricular and ventricular extrasystoles, regardless of the day of the study and the result of OAC. Supraventricular and ventricular tachycardia was recorded incidentally. Atrial or ventricular fibrillation or flutter was not observed. There was no evidence of any ischemic heart disease. In 2 patients, hypotension was registered, but only 1 of them required typical treatment of anaphylaxis.
No clinically significant cardiac arrhythmias were recorded during OAC. The changes observed in the records of blood pressure and ECG monitoring show that OAC performed in accordance with the current guidelines does not pose a high risk to the patient's health and life as a result of cardiovascular reactions.
众所周知,在口服阿司匹林激发试验(OAC)期间给药不仅会引发呼吸系统或皮肤的过敏症状,还会引发心血管系统的过敏症状。
评估疑似对非甾体抗炎药(NSAIDs)过敏的患者在OAC期间心血管不良事件的发生情况及性质。
该研究纳入了52例有阿司匹林(ASA)或其他NSAIDs过敏症状的患者,这些症状在既往病史中表现为皮肤反应或呼吸道反应。患者接受OAC治疗,同时监测对ASA/NSAIDs过敏的临床表现、通气障碍和心血管功能。
在OAC期间,心血管系统最常见的反应是心动过速或室上性及室性期前收缩,与研究日期和OAC结果无关。偶有室上性和室性心动过速记录。未观察到心房或心室颤动或扑动。没有任何缺血性心脏病的证据。2例患者出现低血压,但其中只有1例需要进行典型的过敏反应治疗。
在OAC期间未记录到具有临床意义的心律失常。血压和心电图监测记录中观察到的变化表明,按照现行指南进行的OAC不会因心血管反应而对患者的健康和生命构成高风险。