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G Ital Cardiol (Rome). 2022 Jan;23(1):75-79. doi: 10.1714/3715.37065.

[Management of ST-elevation myocardial infarction in a patient with aspirin hypersensitivity without oral P2Y12 inhibitors].

Giornale italiano di cardiologia (2006)

[Article in Italian]
Matteo Bianco, Carloalberto Biolè, Amanda Spirito, Paola Destefanis, Alessia Luciano, Laura Montagna, Enrico Cerrato

Affiliations

  1. Dipartimento di Cardiologia, A.O.U. San Luigi Gonzaga, Orbassano (TO).
  2. Unità di Cardiologia Interventistica, A.O.U. San Luigi Gonzaga, Orbassano (TO) e Ospedale degli Infermi, Rivoli (TO).

PMID: 34985465 DOI: 10.1714/3715.37065

Abstract

Aspirin hypersensitivity is a neglected issue, especially in the setting of ST-elevation myocardial infarction (STEMI). Nevertheless, in such context a prompt platelet inhibition remains crucial. We report the case of a patient presenting with STEMI, aspirin hypersensitivity and emesis causing inadequate intake of P2Y12 inhibitors managed with intravenous cangrelor therapy and aspirin desensitization. Possible options in the management of aspirin hypersensitivity in the acute phase are discussed. In selected patients with STEMI and aspirin hypersensitivity, particularly in the suspect of suboptimal enteric absorption of P2Y12 inhibitors, the use of cangrelor until aspirin desensitization is completed can be considered; bridge therapy to desensitization with glycoprotein IIb/IIIa inhibitors can be considered on a case by case basis, despite the scarce supporting evidence - bridge therapy with indobufen is not recommended due to the limited literature data.

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