Diagnostic features and literature review of acute coronary syndrome induced by fluorouracil

doi:10.3877/cma.j.issn.2095-655X.2019.03.003

Abstract

Abstract:

Objective

To explore the diagnostic features of acute coronary syndrome induced by fluorouracil.

Methods

A case of acute coronary syndrome after fluorouracil chemotherapy who was treated for colon cancer in the oncology department of Zhongshan Hospital Affiliated to Fudan University was retrospectively analyzed, the relevant literatures were reviewed.

Results

A 60-year-old male colon cancer patient combined with coronary heart disease who underwent percutaneous coronary intervention accepted the first cycle adjuvant chemotherapy FOLFOX (fluorouracil, calcium folinate, oxaliplatin) regimen. On the 14th day after chemotherapy, he developed chest tightness, persistent chest pain, inability to lie flat, sitting breathing and shortness of breath. Both serum cardiac troponin (cTnT) level (0.687 μg/L) and N-terminal pro B-type natriuretic (NT-proBNP) level (7 128 ng/L) increased significantly, ECG revealed persistent myocardial ischemia changes and pulmonary CTA showed no definite embolism signs. Excluding other pathological and drug factors, acute coronary syndrome caused by fluorouracil was considered. After the symptomatic supportive treatment, the levels of cTnT and NT-proBNP reduced gradually while the patient no longer complained of chest tightness or chest pain. The surveillance of ECG and TTE during and after TOMOX(oxaliplatin, raltitrexed) regimen had no difference and the level of cTnT decreased to the normal.

Conclusion

Patients receiving fluorouracil should be monitored carefully of drug-induced cardiotoxicity, such as acute coronary syndrome, to ensure the smooth progress of chemotherapy.

Key words: Fluorouracil, Chemotherapy, adjuvant, Acute coronary syndrome, Coronary heart disease, Colon cancer

Chunhui Wang, Jing Li, Wei Wu, Jinyi Lin, Yuchen Xu, Qianzhou Lyu, Leilei Cheng. Diagnostic features and literature review of acute coronary syndrome induced by fluorouracil[J]. Chinese Journal of Diagnostics(Electronic Edition), 2019, 07(03): 151-154.

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References 13

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指标	入院后第1天	入院后第12天	入院后第17天	入院后第31天	入院后第74天	入院后第187天
心肌肌钙蛋白T(μg/L)	0.687	0.238	0.157	0.051	0.030	0.024
氨基末端利钠肽前体(ng/L)	7 128	4 933	2 487	2 278	1 181	1 118
红细胞计数(×10¹²/L)	2.81	1.47	1.36	1.41	3.49	3.63
血红蛋白(g/L)	83	49	52	60	127	121

指标	入院后第1天	入院后第12天	入院后第17天	入院后第31天	入院后第74天	入院后第187天
心肌肌钙蛋白T(μg/L)	0.687	0.238	0.157	0.051	0.030	0.024
氨基末端利钠肽前体(ng/L)	7 128	4 933	2 487	2 278	1 181	1 118
红细胞计数(×10¹²/L)	2.81	1.47	1.36	1.41	3.49	3.63
血红蛋白(g/L)	83	49	52	60	127	121

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