Allergic vasospastic angina: a systematic review
Authors' conclusion
Allergic vasospastic angina is an important and under-recognised vasospastic angina subtype, often presenting as an acute coronary syndrome. Diagnosis of this disorder is important since management differs to conventional vasospastic angina with the potential of allergen avoidance and use of allergic response modulating therapies.
Study context
- Population
- Reported cases of allergic vasospastic angina (Kounis syndrome)
- Participants
- 393 case reports
- Outcome
- Patient characteristics
Methodological detailsreported cases from 1992 to 2022, Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines
- Reported cases from 1992 to 2022
- Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines
Pooled result
As reported in the abstract
Median age
53 years
Males
64%
One or more cardiovascular risk factors
46%
Atopic history
32%
Further pooled results
Presentation and precipitating allergens
- ST-elevation myocardial infarct
- 71%
- Prescription medications as precipitating allergens
- 55%
- Most patients presented with an acute coronary syndrome
- Multiple potential allergic mechanisms including immunoglobulin-E (IgE)-mediated mast cell degranulation, eosinophil-mediated allergic response and other non-IgE mediated mast cell activation pathways
Original publication
Allergic vasospastic angina: a systematic review. Heart. Published 5 November 2025. doi:10.
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