Type 1 Kounis syndrome after paclitaxel infusion in a patient treated for lung adenocarcinoma

Wang, Benjamen; Sethwala, A.; Gurvitch, Ronen

doi:10.1111/imj.15226

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Nab-paclitaxel, which is similar to paclitaxel, contains human albumin particles instead of Cremophor El and the hypersensitivity reactions are fewer. Kounis syndrome associated with hypersensitivity has occurred in patients treated with paclitaxel administration [ 26 , 27 ]. Moreover, drug-coated balloons are used widely as a form of endovascular treatment for peripheral arterial disease.…”

Section: Hypersensitivity To Cytotoxic Agents and Kounis Syndromementioning

confidence: 99%

Cardio-Oncoimmunology: Cardiac Toxicity, Cardiovascular Hypersensitivity, and Kounis Syndrome

Kounis,

Hung,

de Gregorio

et al. 2024

Life

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Cancer therapy can result in acute cardiac events, such as coronary artery spasm, acute myocardial infarction, thromboembolism, myocarditis, bradycardia, tachyarrhythmias, atrio-ventricular blocks, QT prolongation, torsades de pointes, pericardial effusion, and hypotension, as well as chronic conditions, such as hypertension, and systolic and diastolic left ventricular dysfunction presenting clinically as heart failure or cardiomyopathy. In cardio-oncology, when referring to cardiac toxicity and cardiovascular hypersensitivity, there is a great deal of misunderstanding. When a dose-related cardiovascular side effect continues even after the causative medication is stopped, it is referred to as a cardiotoxicity. A fibrotic response is the ultimate outcome of cardiac toxicity, which is defined as a dose-related cardiovascular adverse impact that lasts even after the causative treatment is stopped. Cardiotoxicity can occur after a single or brief exposure. On the other hand, the term cardiac or cardiovascular hypersensitivity describes an inflammatory reaction that is not dose-dependent, can occur at any point during therapy, even at very low medication dosages, and can present as Kounis syndrome. It may also be accompanied by anti-drug antibodies and tryptase levels. In this comprehensive review, we present the current views on cardiac toxicity and cardiovascular hypersensitivity, together with the reviewed cardiac literature on the chemotherapeutic agents inducing hypersensitivity reactions. Cardiac hypersensitivity seems to be the pathophysiologic basis of coronary artery spasm, acute coronary syndromes such as Kounis syndrome, and myocarditis caused by cancer therapy.

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Section: Hypersensitivity To Cytotoxic Agents and Kounis Syndromementioning

confidence: 99%

Cardio-Oncoimmunology: Cardiac Toxicity, Cardiovascular Hypersensitivity, and Kounis Syndrome

Kounis,

Hung,

de Gregorio

et al. 2024

Life

View full text Add to dashboard Cite

show abstract

“…Nab-Paclitaxel which is similar to paclitaxel contains human albumin particles instead of Cremophor El and hypersensitivity reactions are less. Kounis syndrome associated with hypersensitivity has occurred in treated patients with paclitaxel administration [38,39]. Moreover, drug-coated balloons are used widely as a form of endovascular treatment for peripheral arterial disease.…”

Section: Hypersensitivity To Cytotoxic Agents and The Kounis Syndromementioning

confidence: 99%

Cardio-Oncology: Cardiac Toxicity, Cardiovascular Hypersensitivity and Kounis Syndrome

Kounis,

Hung,

De Gregorio

et al. 2024

Preprint

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The most frequent cause of cardiac failure globally is ischemic heart disease, with chemothera-py-related cardiovascular side effects emerging as the second most frequent cause. Cancer therapy can result in acute cardiac events, such as coronary artery spasm, acute myocardial infarction, thromboembolism, myocarditis, bradycardia, tachyarrhythmias, atrio-ventricular blocks, QT pro-longation, torsades de pointes, pericardial effusion and hypotension, as well as chronic conditions, such as hypertension, systolic and diastolic left ventricular dysfunction presenting clinically as heart failure or cardiomyopathy. In cardio-oncology, when referring to cardiac toxicity and cardiovas-cular hypersensitivity, there is a great deal of misunderstanding. When a dose-related cardiovas-cular side effect continues even after the causative medication is stopped, it is referred to as cardi-otoxicity. A fibrotic response is the ultimate outcome of cardiac toxicity, which is defined as a dose-related cardiovascular adverse impact that lasts even after the causative treatment is stopped. Cardiotoxicity can occur after a single or brief exposure. On the other hand, the term cardiac or cardiovascular hypersensitivity describes an inflammatory reaction that is not dose-dependent, can occur at any point during therapy, even with very low medication dosages, and can show up as Kounis syndrome. It may also be accompanied by anti-drug antibodies and tryptase levels. In this comprehensive review, we present the current views on cardiac toxicity and cardiovascular hypersensitivity, together with the reviewed cardiac literature on the chemotherapeutic agents inducing hypersensitivity reactions. Cardiac hypersensitivity seems to be the pathophysiologic basis of coronary artery spasm, acute coronary syndromes such as Kounis syndrome and myocardi-tis caused by cancer therapy.

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Kounis Syndrome: Review of Clinical Cases

Yakushin,

Gurbanova,

Pereverzeva

2024

CHDDT

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Background: Kounis syndrome is defined as a combination of acute coronary syndrome and allergic reactions. Objective: In this review, we aim to describe the etiological, clinical, and diagnostic characteristics of Kounis syndrome. Methods: A literature search using PubMed was conducted for the past 32 years using keywords, resulting in the selection of 761 scientific papers. From these, 217 articles describing 235 clinical cases were selected. Patients under 18 years of age or without a confirmed diagnosis were excluded. Results: Among the 235 patients, type I Kounis syndrome was observed in 49.7%, type II in 27.2%, type III in 5.9%, and a combination of types I and II in 1.0%; in 16.2%, it was not possible to classify the type of Kounis syndrome. The median age was 57 years, and 68.5% of the patients were male. The most common causes were antibiotics (32.3%) and non-steroidal anti-inflammatory drugs (24.3%). The clinical features included chest pain (59.1%), hypotension (74.2%), itching (30.6%), and dyspnea (30.6%). Electrocardiographic monitoring revealed ST-segment elevation in 42.9% and was normal in only 5.5% of patients. Coronary angiography was performed in 80.4% of the patients, revealing unchanged coronary arteries in 50.3% of cases. Сonclusion: Allergic myocardial infarction is a serious complication of drug therapy

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Type 1 Kounis syndrome after paclitaxel infusion in a patient treated for lung adenocarcinoma

Cited by 3 publications

References 6 publications

Cardio-Oncoimmunology: Cardiac Toxicity, Cardiovascular Hypersensitivity, and Kounis Syndrome

Cardio-Oncoimmunology: Cardiac Toxicity, Cardiovascular Hypersensitivity, and Kounis Syndrome

Cardio-Oncology: Cardiac Toxicity, Cardiovascular Hypersensitivity and Kounis Syndrome

Kounis Syndrome: Review of Clinical Cases

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