Sibutramine-induced acute myocardial infarction in a young lady

Abstract

Introduction. Sibutramine is an amphetamine-like drug used for its weight reducing effect. Sibutramine-induced acute coronary syndrome has rarely been reported. We report a case of myocardial infarction associated with the use of sibutramine. Case Report. A 37-year-old woman presented to an Emergency Department (ED) with intermittent retrosternal chest pain, nausea, and sweating for 3 days. She reported taking one sibutramine tablet each day for 3 days. Blood pressure was 128/89 mm Hg and pulse 66 beats/min. An electrocardiogram revealed ST elevation over the inferior leads and ST depression over leads AVR and V1, the other leads were normal. Serum troponin T was 0.65 μg/L, and sibutramine was identified in her urine. Echocardiography revealed mild hypokinesia over the inferior wall without evidence of acute aortic dissection. The ST segment changes resolved spontaneously within 24 h of cardiac care unit (CCU) admission, a coronary angiogram performed 1 week later was unremarkable, and echocardiography performed 4 weeks after the event showed normal resting regional wall motion. Discussion. Seventeen medications containing sibutramine as an active ingredient were registered in Hong Kong in 2007. Sibutramine was introduced in the United States in 1997 and in Australia, United Kingdom, and Italy in 2001. Hypertension, tachycardia, dry mouth, and headache are the most commonly reported adverse reactions. Cardiovascular toxicities include tachycardia, palpitation, hypertension, and tachyarrhythmia. Conclusions. We postulate that the myocardial infarction was the result of coronary vasospasm associated with the therapeutic use of sibutramine-containing slimming pills.

ChemDIS: a chemical–disease inference system based on chemical–protein interactions

“…Similar to maleic acid, there is only five genes curated in CTD database giving only partial interaction information making the disease inference difficult. Sibutramine is originally indicated for the management of obesity and has been withdrawn from the market due to the concern of cardiotoxicity [15, 16]. The reported adverse effects associated with sibutramine include symptoms of cardiovascular, nervous and gastrointestinal system diseases and disease of mental health.…”

Cardiovascular Risk-Benefit Profile of Sibutramine

“…[92][93][94][95] Although it is practically impossible to demonstrate a causal relation, the patient's age, the absence of any attendant CVD risk factors and/or the negative results of the other studies (including coronary angiography), together with the coincidence between the start of drug treatment for obesity, led to the conclusion that the use of sibutramine was probably responsible for the myocardial infarction, possibly as the result of coronary vasospasm. In another report, sibutramine was also considered as a possible cause of a reversible cardiomyopathy.…”

Association of CYP2B6, CYP3A5, and CYP2C19 Genetic Polymorphisms With Sibutramine Pharmacokinetics in Healthy Korean Subjects

“…In 2002, it was temporarily withdrawn in Italy after 103 serious adverse reactions, including two deaths, were reported in the United Kingdom 17 . In the period from the drug's introduction to the US market in February 1998 through the end of September 2001, 397 serious adverse reactions were reported to the US Food Drug and Administration 18 , 19 . Of these 397 patients, 152 were hospitalized, and there were 29 deaths, of which 19 were attributed to cardiovascular etiologies 20 .…”