Gemcitabine and Acute Myocardial Infarction

Bdair, Fadi; Graham, Susan; Smith, Patrick F.; Javle, Milind

doi:10.1177/000331970605700314

Cited by 25 publications

(13 citation statements)

References 15 publications

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“…Interestingly, all the patients who developed AMI related to gemcitabine therapy had pre-existing CAD. Two of these patients were already on appropriate antianginal medications before they experienced gemcitabine-related myocardial ischemia [17,18]. In another patient with a previous episode of gemcitabine-induced myocardial ischemia, the next gemcitabine infusion was started concomitantly with IV nitroglycerine and beta blockers [19].…”

Section: Discussionmentioning

confidence: 99%

Gemcitabine-induced cardiomyopathy: a case report and review of the literature

et al. 2014

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IntroductionNewly developed antineoplastic drugs have resulted in improvements in morbidity and mortality from many forms of cancers. However, some of these new chemotherapeutic agents have potentially lethal side effects, which are now being exposed with their widespread use. Gemcitabine is a nucleoside analog, which is a commonly used agent for various solid organ malignancies. Phase 1 and 2 trials with gemcitabine did not show significant risk for cardiotoxicity; however, with its widespread clinical use over the last decade, a few cases of cardiotoxicity related to gemcitabine use have been reported. Cardiomyopathy after the use of gemcitabine monotherapy is extremely rare; and only one such case has been reported in detail previously.Case presentationWe report a case of a 56-year-old African American man with pancreatic cancer who presented with signs and symptoms of congestive heart failure after being treated with gemcitabine for two cycles (six doses). A two-dimensional echocardiography showed left ventricular ejection fraction of 15 to 20 percent with global hypokinesia. With the absence of significant risk factors for coronary artery disease and a strong temporal relationship with the initiation of chemotherapy, it was concluded that our patient’s cardiomyopathy was related to the use of gemcitabine. Gemcitabine was discontinued and our patient responded well to standard heart failure therapy. Two months later, a repeat echocardiogram showed significant improvements in left ventricular systolic function.ConclusionsGemcitabine should be considered as a potential cause of cardiomyopathy in patients receiving chemotherapy with this drug. We need further studies to look into potential mechanisms and treatments of gemcitabine-induced cardiac dysfunction.

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Section: Discussionmentioning

confidence: 99%

Gemcitabine-induced cardiomyopathy: a case report and review of the literature

et al. 2014

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“…This side effect is likely because of a gemcitabine metabolite, 2′,2′‐difluorodeoxyuridine (diFdU), which has a an equivalent half‐life of approximately 18–24 h similar to the time of onset of atrial fibrillation 8, 9. Several case reports have demonstrated acute myocardial infarction acutely post‐gemcitabine infection secondary to drug‐induced vascular injury or endothelial damage 10, 11, 12…”

Section: Discussionmentioning

confidence: 99%

Gemcitabine induced cardiomyopathy: a case of multiple hit cardiotoxicity

2016

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Gemcitabine is a commonly used antineoplastic agent used to treat a variety of cancers with rarely reported cardiac side effects. We describe a case of a 67‐year‐old woman with follicular lymphoma who experienced a rarely reported side effect of gemcitabine: cardiomyopathy. This case highlights a multiple hit mechanism of myocyte damage that may occur following the use of multiple cardio‐toxic agents despite their administration in doses not associated with cardiotoxicity.

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“…Bdair et al [10] reported a case with previous myocardial infarction history, which developed AMI 3 days after gemcitabine therapy. Our subject, who had a history of coronary artery disease, developed chest pain with accompanying newly developed LBBB shortly after drug infusion, but no biomarker increases were observed and both symptoms and LBBB resolved with antianginal treatment.…”

Section: Discussionmentioning

confidence: 99%

Gemcitabine-Induced Acute Coronary Syndrome: A Case Report

Öztürk¹,

Taçoy

Coskun³

et al. 2008

Med Princ Pract

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Objectives: To report a case of metastatic leiomyosarcoma, in which a patient developed chest pain accompanied by acute left bundle-branch block (LBBB) after gemcitabine infusion. Clinical Presentation and Intervention: A 59-year-old woman admitted with bilateral pulmonary nodules had classic risk factors for coronary heart disease and coronary stenosis as demonstrated by previous coronary angiography. She was treated with gemcitabine infusion, and 30 min later she experienced severe chest pain accompanied by acute LBBB confirmed by ECG. We suspected gemcitabine-induced coronary vasospasm exacerbated by the preexisting coronary artery disease as the cause of the acute coronary syndrome. The patient was subsequently treated with antianginal therapy and percutaneous coronary intervention. Her chest pain resolved and LBBB disappeared. She was discharged 2 days later without any further cardiac events. No additional cancer therapy was given and she died 5 months later, due to disease progression. Conclusion: This case showed that chemotherapeutic agents must be administered with intensive cardiac monitoring especially in patients with cardiac disease and well-known risk factors to prevent the development of cardiac complications, despite an agent not being known to be ‘cardiotoxic’.

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Gemcitabine and Acute Myocardial Infarction

Cited by 25 publications

References 15 publications

Gemcitabine-induced cardiomyopathy: a case report and review of the literature

Gemcitabine-induced cardiomyopathy: a case report and review of the literature

Gemcitabine induced cardiomyopathy: a case of multiple hit cardiotoxicity

Gemcitabine-Induced Acute Coronary Syndrome: A Case Report

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