Allergic reactions during coronary angiography or PCI in Poland: Occurrence, trends and predictors. Long-term perspective based on ORPKI registry.

Abstract

Background: Allergic reactions during coronary angiography and percutaneous coronary intervention (PCI) in patients with acute coronary syndromes can affect their outcome.

Aims: To investigate the incidence of allergic reactions and predictors to their occurrence in the catheterization laboratory.

Methods: The study included 1 812 994 treatments available in the ORPKI Polish National Registry, of which 659 372 were for women and 1 144 689 for men. Data were collected from 161 interventional cardiology centers in Poland between 2014 and 2022 and included in the retrospective analysis. An allergic reaction was defined as any hypersensitive response of the immune system manifesting as bronchospasm, asthma exacerbation, conjunctivitis, urticaria, eczema, angioedema, anaphylactic shock.

Results: There was a decreasing incidence of allergic reactions overall, both gender subgroups and subgroups of age decades. The incidence of allergic reactions in each year oscillated between 0.02% and 0.11% (P <0.001) and the most recent one was 0.02% in 2022. The incidence of allergic reaction is associated with low-molecular-weight heparin (LMWH) (OR, 23.5 [95% CI, 18.92-29.19]), glycoprotein IIb/IIIa inhibitors (GPI IIb/IIIa) (OR, 2.31 [95% CI, 1.92-2.78]), previous PCI (OR, 1.55 [95% CI, 1.34-1.8]), dose of radiation (OR, 1.25 per 1000 mGy [95% CI, 1.19-1.31]), dose of contrast (OR, 1.17 per 100 ml [95% CI, 1.08-1.28]).

Conclusions: The overall incidence of acute allergic reactions in cathlab is low and has decreased significantly between 2014 and 2022. The decrease in frequency did not depend on age or gender. Independent predictors of allergic reaction incidence were the use of GPI IIb/IIIa, LMWH , dose of contrast agent and dose of radiation.