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Oncologist. 2019 Dec 16. pii: theoncologist.2019-0762. doi: 10.1634/theoncologist.2019-0762. [Epub ahead of print]

Fluoropyrimidine-Associated Cardiotoxicity: A Retrospective Case-Control Study.

Author information

1
Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
2
Department of Pharmacy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
3
Department of Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
4
Division of Medical Oncology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
5
Department of Cardiovascular Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA aasnani@bidmc.harvard.edu.

Abstract

BACKGROUND:

The fluoropyrimidines, 5-fluorouracil (5-FU) and capecitabine, are commonly used chemotherapeutic agents that have been associated with coronary vasospasm.

METHODS:

In this retrospective case-control study, we identified patients at our institution who received 5-FU or capecitabine in 2018. We compared characteristics of patients who experienced cardiotoxicity with controls. We described phenotypes and outcomes of cardiotoxic cases.

RESULTS:

We identified 177 patients who received fluoropyrimidines. After adjudication, 4.5% of the cohort met the criteria for cardiovascular toxicity. Coronary artery disease was more common among cases than controls (38% vs. 7%, p < .05). There was also a trend toward increased prevalence of cardiovascular risk factors in cases compared with controls. Most cardiotoxic cases had chest pain, although a minority of cases presented with nonischemic cardiomyopathy.

CONCLUSION:

Cardiotoxicity phenotypes associated with fluoropyrimidine use are not limited to coronary vasospasm. Cardiac risk factors and ischemic heart disease were highly prevalent among patients with cardiotoxicity.

KEYWORDS:

Capecitabine; Cardiotoxicity; Fluorouracil

PMID:
31843972
DOI:
10.1634/theoncologist.2019-0762
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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

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