Iranian Heart Association Iranian Heart Journal 27 1 2026 01 01 Undertaking Unexpected Catastrophe: Dual Antiplatelet Allergy in a Patient With Acute ST-Elevation Myocardial Infarction 88 92 237767 EN Zakka Zayd Zhullatullah Jayadisastra Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia. 0000-0001-9050-9502 Putrika Prastuti Ratna Gharini Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia. 0000-0001-7847-8010 Hendry Purnasidha Bagaswoto Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia. 0000-0002-1140-8154 Budi Yuli Setianto Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia. 0000-0002-8514-3072 Deshinta Putri Mulya Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada – Dr. Sardjito General Hospital, Yogyakarta, Indonesia. 0000-0002-7607-9574 Journal Article 2025 06 09 <span style="font-size: 12.0pt; font-family: 'Times New Roman','serif';">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. </span><strong><em><span style="font-size: 10.0pt; font-family: 'Times New Roman','serif'; color: #984806; letter-spacing: -.1pt;">(Iranian Heart Journal 2026; 27(1): 88-92)</span></em></strong> https://journal.iha.org.ir/article_237767_4a215034a319e370069a2592aa7498d3.pdf