Iranian Heart Journal

Iranian Heart Journal

Undertaking Unexpected Catastrophe: Dual Antiplatelet Allergy in a Patient With Acute ST-Elevation Myocardial Infarction

Document Type : Case Report

Authors
Zakka Zayd Zhullatullah Jayadisastra 1
Putrika Prastuti Ratna Gharini 1
Hendry Purnasidha Bagaswoto 1
Budi Yuli Setianto 1
Deshinta Putri Mulya 2
1 Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
2 Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
Abstract
Acute coronary syndrome (ACS) is caused by a thrombotic condition in the coronary arteries. It may present as acute ST-segment elevation myocardial infarction (STEMI) or non–ST-segment elevation acute coronary syndrome (NSTEACS). Dual antiplatelet therapy (DAPT) is the primary strategy to reduce mortality and prevent future thrombosis in patients with acute STEMI. Nonetheless, allergy to these agents remains a clinical challenge during treatment. We describe a 68-year-old man with inferolateral STEMI who developed an allergic reaction to acetylsalicylic acid and clopidogrel after administration of a loading dose of DAPT. The patient was treated with fibrinolysis, which was considered successful. Angiography was not performed because of the patient’s antiplatelet allergy. The DAPT allergy was successfully managed by reintroducing and rapidly desensitizing DAPT through the ADAPTED registry protocol. Alternative strategies are available when desensitization is not feasible. (Iranian Heart Journal 2026; 27(1): 88-92)
Keywords
DAPT
allergy
ACS
STEMI
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Iranian Heart Journal
Volume 27, Issue 1
Winter 2026
Pages 88-92