| Cardiotoxicity following different doses and schedules of 5-fluorouracil administration for malignancy -- a survey of 427 patients. | |
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MedLine Citation:
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PMID: 12070449 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Nicolas Tsavaris; Christos Kosmas; Maria Vadiaka; Michalis Efremidis; Andreas Zinelis; Dimitris Beldecos; Dimitris Sakelariou; Christos Koufos; George Stamatelos |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2002-06-18 Completed Date: 2002-12-26 Revised Date: 2010-03-23 |
Medline Journal Info:
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Nlm Unique ID: 9609063 Medline TA: Med Sci Monit Country: Poland |
Other Details:
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Languages: eng Pagination: PI51-7 Citation Subset: IM |
Affiliation:
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Department of Pathophysiology, Oncology Unit, Laikon General Hospital, Athens University School of Medicine, Greece. ckosm@ath.forthnet.gr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antimetabolites, Antineoplastic / administration & dosage, adverse effects* Dose-Response Relationship, Drug Drug Administration Schedule Electrocardiography Female Fluorouracil / administration & dosage, adverse effects* Heart / drug effects*, physiopathology Humans Male Middle Aged Neoplasms / drug therapy*, physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Antimetabolites, Antineoplastic; 51-21-8/Fluorouracil |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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