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PubMed · 2170140

5-Fluorouracil cardiotoxicity.

Abstract

The authors report a case of cardiotoxicity secondary to 5-FU, the 67th in literature in a 46-year-old woman subjected to adjuvant therapy with a CMF protocol after surgical treatment for carcinoma of the breast, and presenting onset of clinical symptoms 16 hours after administration of the first dose. Analysis of previous cases reported in literature revealed no evidence of age or sex as risk factors. Doubts exist as to whether or not pre-existing heart disease and thoraco-mediastinic radiotherapy increase the risk. With regard to the causes of the syndrome, the authors are inclined to attribute its onset to an auto-immune mechanism. 5-FU-induced cardiotoxicity, though rare, should be borne in mind and the use of the drug should be discontinued at the first signs of cardiotoxicity.

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BibTeXRIS

A M Lomeo, C Avolio, G Iacobellis, L Manzione. 1990. 5-Fluorouracil cardiotoxicity.. https://pubmed.ncbi.nlm.nih.gov/2170140/

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Effect of a hypoglycemic agent on ischemic preconditioning in patients with type 2 diabetes and stable angina pectoris.

OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

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