Abstract
Abstract
Objective: To describe the occurrence and outcomes of anaphylaxis incidents during and after coronary angiography and intervention procedures at the Vietnam National Heart Institute, Bach Mai Hospital, and to evaluate the effectiveness of management strategies.
Subjects and Methods: This study included 107 patients undergoing coronary angiography and/or intervention who developed anaphylaxis within 24 hours of the procedure, diagnosed and managed according to Circular 51/2017-TT-BYT. Clinical symptoms, laboratory findings, and outcomes were recorded from August 2023 to July 2024.
Results: Anaphylaxis occurred in 1.26% of cases, with 38% of incidents during the procedure and 62% post-procedure. Chills were the most frequent symptom (90.7%). Post-procedure anaphylaxis was more severe compared to intra-procedure cases (62.1% vs. 41.5%, p = 0.037). Elevated CRPhs levels (> 5 mg/L) were identified as a significant risk factor for post-procedure anaphylaxis (OR = 4.929, p < 0.05). Blood lactate levels were positively correlated with anaphylaxis severity (p = 0.002). Adrenaline was administered in all grade II cases, with post-procedure cases requiring adrenaline 2.04 times more often. The discharge rate was 94%, with a 1% in-hospital mortality rate.
Conclusion: Anaphylaxis incidents during and after coronary angiography and intervention require prompt recognition and management. Post-procedure anaphylaxis is associated with greater severity, influenced by elevated CRPhs and lactate levels. Adrenaline administration remains critical for severe cases, and most patients recover with appropriate management.
Keywords: anaphylaxis, coronary angiography, contrast media, adrenaline, CRPhs, lactate