5‐Fluorouracil—Induced Tako‐Tsubo—Like Syndrome

Basselin, P D Cécile; Fontanges, Thierry; Descotes, Jacques; Chevalier, Philippe; Bui‐Xuan, Bernard; Feinard, P D Gwennaelle; Timour, Quadiri

doi:10.1592/phco.31.2.226

Cited by 55 publications

(34 citation statements)

References 2 publications

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“…Patients appear to recover normal cardiac function within weeks after discontinuing the drug. 134,135 Targeted Therapies Trastuzumab, a humanized monoclonal antibody targeted against the extracellular domain of the human epidermal growth factor receptor 2 (ErbB2 receptor), is used widely in the treatment of ErbB2 receptor-positive breast carcinoma. 136 In some patients, this agent induces significant cardiac dysfunction, presumably because of the inhibition of the ErbB2 signaling pathway within cardiomyocytes.…”

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confidence: 99%

Drugs That May Cause or Exacerbate Heart Failure

Page¹,

O’Bryant²,

Cheng³

et al. 2016

Circulation

357

185

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Heart failure is a common, costly, and debilitating syndrome that is associated with a highly complex drug regimen, a large number of comorbidities, and a large and often disparate number of healthcare providers. All of these factors conspire to increase the risk of heart failure exacerbation by direct myocardial toxicity, drug-drug interactions, or both. This scientific statement is designed to serve as a comprehensive and accessible source of drugs that may cause or exacerbate heart failure to assist healthcare providers in improving the quality of care for these patients.

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mentioning

confidence: 99%

Drugs That May Cause or Exacerbate Heart Failure

Page¹,

O’Bryant²,

Cheng³

et al. 2016

Circulation

357

185

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“…At present, only five patients with TTS caused by fluorouracil treatment have been reported [6][7][8][9][10]. To the best of our knowledge, the present case is only the sixth.…”

Section: Introductionmentioning

confidence: 81%

“…Fluorouracil-induced TTS is a recently recognized syndrome [6][7][8][9][10]. To the best of our knowledge, there have been only 10 reported cases, of which five were diagnosed as TTS ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…concomitant use of leucovorin has a significant impact on cardiotoxicity [18]. In six of the previously reported cases, TTS occurred following infusional fluorouracil [6,8,[12][13][14] and in one case, TTS was triggered by capecitabine [9,14]. In six reports, leucovorin was co-administered with fluorouracil [6,8,10,12,14].…”

Section: Discussionmentioning

confidence: 99%

“…In six of the previously reported cases, TTS occurred following infusional fluorouracil [6,8,[12][13][14] and in one case, TTS was triggered by capecitabine [9,14]. In six reports, leucovorin was co-administered with fluorouracil [6,8,10,12,14]. In most cases (n ¼ 8), TTS occurred during the first cycle of fluorouracil [6,8,9,[11][12][13][14]; however, in three cases, it was observed after serial exposure to the drug [7,10].…”

Section: Discussionmentioning

confidence: 99%

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Takotsubo syndrome

Öztürk¹,

Özveren²,

Cinar³

et al. 2013

Blood Coagulation &Amp; Fibrinolysis

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Takotsubo syndrome (TTS)/cardiomyopathy is a syndrome that mimics acute myocardial infarction in the absence of coronary artery disease and is characterized by acute onset of chest pain, electrocardiographic abnormalities, and reversible left ventricular dysfunction. It is usually induced by emotional and physical stress. Fluorouracil is one of the most frequently used chemotherapy agents and a relatively common adverse reaction of fluorouracil is cardiotoxicity. Herein we describe a patient without a history of cardiovascular disorder who developed severe heart failure during infusion of fluorouracil for metastatic gastric cancer. Remarkably, the patient did not develop TTS during prior chemotherapy regimen, which also included fluorouracil. The patient's findings were consistent with the proposed TTS diagnostic criteria and coronary angiography was normal, without obstructive coronary artery disease. With supportive care, the patient's cardiac functions returned to normal. TTS is not a well known syndrome to clinicians and this condition appears to occur more frequently than previously thought. In addition to the presented case, a review of the clinical features and outcome of 10 reported cases of fluorouracil-induced TTS is presented.

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Myocardial Ischemia Induced by 5-Fluorouracil: A Prospective Electrocardiographic and Cardiac Biomarker Study

et al. 2020

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Background. Cardiotoxicity induced by 5-fluorouracil (5-FU) is well known but poorly understood. In this study, we undertook ECG recording (Holter) and analyses of the biomarkers troponin and copeptin in patients receiving 5-FU to increase our understanding of the cardiotoxicity. Subjects, Materials, and Methods. Patients with colorectal or anal cancer that received first-time treatment with 5-FUbased chemotherapy were prospectively included. Holter recording, clinical evaluation, 12-lead electrocardiogram, and assessment of plasma concentrations of troponin I and copeptin were performed before (control) and during 5-FU treatment (intervention). Results. A total of 108 patients were included, 82 with colorectal and 26 with anal cancer. The proportion of patients with myocardial ischemia on Holter recording was significantly higher during the first 5-FU infusion (14.1%) than before (3.7%; p = .001). The ischemic burden per day (p = .001), the number of ST depression episodes per day (p = .003), and the total duration of ischemic episodes per day (p = .003) were higher during the first 5-FU infusion than before, as was plasma copeptin (p < .001), whereas plasma troponin I was similar (p > 0.999). Six patients (5.6%) developed acute coronary syndromes and two (1.8%) developed symptomatic arrhythmias during 5-FU treatment. Conclusion. 5-FU infusion is associated with an increase in the number of patients with myocardial ischemia on Holter recording. According to biomarker analyses, 5-FU is associated with an increase in copeptin, but rarely with increases in cardiac troponin I. However, 5%-6% of the patients developed acute coronary syndromes during treatment with 5-FU.

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5‐Fluorouracil—Induced Tako‐Tsubo—Like Syndrome

Cited by 55 publications

References 2 publications

Drugs That May Cause or Exacerbate Heart Failure

Drugs That May Cause or Exacerbate Heart Failure

Takotsubo syndrome

Myocardial Ischemia Induced by 5-Fluorouracil: A Prospective Electrocardiographic and Cardiac Biomarker Study

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