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

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

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

Material and methods: The study included 1 812 994 treatment cases 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, or anaphylactic shock.

Results: There was a decreasing incidence of allergic reactions overall, in both sexes and all age subgroups. The incidence of allergic reactions 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 was 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]), radiation dose (OR, 1.25 per 1000 mGy [95% CI, 1.19-1.31]), and contrast dose (OR, 1.17 per 100 ml [95% CI, 1.08-1.28]).

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