Document Detail

Cardiotoxicity following different doses and schedules of 5-fluorouracil administration for malignancy -- a survey of 427 patients.
MedLine Citation:
PMID:  12070449     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although cardiotoxicity associated with 5-Fluorouracil (5-FU) administration is infrequent, there are case reports of acute coronary syndromes. We report on patients undergoing 5-FU chemotherapy who developed cardiac symptoms during its administration.MATERIAL/METHODS: In patients receiving 5-FU who experienced cardiac-related symptoms, ECG and serum cardiac enzyme determination were performed. If cardiotoxicity was detected, 5-FU infusion was interrupted, and the patients received sublingual nitrates and cardiac monitoring, while patients with more than 2-fold elevated enzyme levels were monitored in a coronary care unit for at least 72 hours. In cases of acute myocardial infarction, 5-FU was terminated. RESULTS: Of 427 patients entering the study, 17 (4%) developed clinical symptoms and ECG abnormalities indicating 5-FU cardiotoxicity. Patients with continuous infusion (c.i.) of 5-FU had a higher incidence of cardiotoxicity (12/197, 6%) than the remaining (5/235, 2.1%) (p=0.067), but more toxicity was encountered in patients with c.i. of 5-FU+LV for 24 hours for 5 days than in patients with the same regimen of 5-FU without LV (p<0.027) or patients with short 5-FU+LV administration (p=0.024). Seven of the 17 patients with 5-FU cardiotoxicity had an acute myocardial infarction, 4 developed ischemic changes, while 4 more patients had ECG abnormalities consistent with coronary vasospasm, of whom one subsequently died. CONCLUSIONS: The present study supports the toxic effect of 5-FU on myocardium, which is largely schedule-dependent. Considerable vigilance is required when using this drug, and its toxic effect on the coronary endothelium and myocardium merit further investigation.
Nicolas Tsavaris; Christos Kosmas; Maria Vadiaka; Michalis Efremidis; Andreas Zinelis; Dimitris Beldecos; Dimitris Sakelariou; Christos Koufos; George Stamatelos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical science monitor : international medical journal of experimental and clinical research     Volume:  8     ISSN:  1234-1010     ISO Abbreviation:  Med. Sci. Monit.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-18     Completed Date:  2002-12-26     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  9609063     Medline TA:  Med Sci Monit     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  PI51-7     Citation Subset:  IM    
Department of Pathophysiology, Oncology Unit, Laikon General Hospital, Athens University School of Medicine, Greece.
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MeSH Terms
Antimetabolites, Antineoplastic / administration & dosage,  adverse effects*
Dose-Response Relationship, Drug
Drug Administration Schedule
Fluorouracil / administration & dosage,  adverse effects*
Heart / drug effects*,  physiopathology
Middle Aged
Neoplasms / drug therapy*,  physiopathology
Reg. No./Substance:
0/Antimetabolites, Antineoplastic; 51-21-8/Fluorouracil

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