Some patients with imperative cardiologic indications for combination therapy with aspirin and clopidogrel (stent placement and/or acute coronary syndrome<sup>1Steinhubl S.R., Berger S., Mann J.T., Fry E.T.A., DeLago A., Wilmer C., Topol E.J.Credo Investigators Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention JAMA 2002 ;  288 : 2411-2420 [cross-ref]

Cliquez ici pour aller à la section Références, 2Mehta S.R., Yusuf S., Peters R.J., Bertrand M.E., Lewis B.S., Natarajan M.K., Malmberg K., Rupprecht H., Zhao F., Chrolavicius S., Copland I., Fox K.A. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study Lancet 2001 ;  358 : 527-533 [cross-ref]

Cliquez ici pour aller à la section Références</sup>) have a history of allergy to aspirin. In other patients, symptoms of aspirin hypersensitivity may develop in the days after stenting, at which time discontinuation of aspirin carries a risk of catastrophic stent thrombosis.<sup>3Kaluza G.L., Joseph J., Lee J.R., Raizner M.E., Raizner A.E. Catastrophic outcomes of noncardiac surgery soon after coronary stenting J Am Coll Cardiol 2000 ;  35 : 1288-1294 [cross-ref]

Cliquez ici pour aller à la section Références</sup> We challenged 16 such patients using rapidly escalating low doses of aspirin. In 14 patients, reintroduction was immediately successful, and 11 underwent uneventful stent placement. Two patients developed transient allergic reactions, 1 of whom was successfully rechallenged 48 hours later. No late allergic reactions or adverse cardiac events were seen after a mean follow-up of 14 months. A rapid challenge-desensitization procedure may allow introduction of aspirin at therapeutic doses within a few hours.