Abstract
Cardiac side effects of the cytostatic agent 5-fluorouracil (5-FU) have an incidence of 1.2 - 7.6%. Potentially, arrhythmias, myocardial infarction and sudden cardiac death could occur. Life-threatening cardiotoxicity is rarely observed with a frequency < 1%. Cardiotoxicity of 5-FU seems to differ from well known effects of other cytostatics, e.g., anthracyclines. Myocardial ischemia was suggested as potential mechanism due to occasionally observed ECG alterations during 5-FU administration. Experimental studies revealed potential mechanisms of cardiotoxicity ranging from direct toxic effects on vascular endothelium involving endothelial NO synthase leading to coronary spasms and endothelium independent vasoconstriction via protein kinase C. In addition, rheological side effects have to be considered. Coronary artery disease is judged to increase the risk of cardiac side effects. Despite lack of prospective trials, verapamil type calcium antagonists as well as nitrates seem to be useful for treatment of 5-FU induced coronary spasms. In addition, modification of the cytostatic regimen has to be considered in patients who had been symptomatic. It could be assumed that 5-FU toxicity is reversible in the majority of cases when acute complications, e.g., arrhythmias, are resolved.
Keywords: 5-fluorouracil, cardiotoxicity, coronary spasm, angina pectoris, arrhythmia
Cardiovascular & Hematological Agents in Medicinal Chemistry
Title: Cardiotoxicity of 5-Fluorouracil
Volume: 4 Issue: 1
Author(s): P. Alter, M. Herzum, M. Soufi, J. R. Schaefer and B. Maisch
Affiliation:
Keywords: 5-fluorouracil, cardiotoxicity, coronary spasm, angina pectoris, arrhythmia
Abstract: Cardiac side effects of the cytostatic agent 5-fluorouracil (5-FU) have an incidence of 1.2 - 7.6%. Potentially, arrhythmias, myocardial infarction and sudden cardiac death could occur. Life-threatening cardiotoxicity is rarely observed with a frequency < 1%. Cardiotoxicity of 5-FU seems to differ from well known effects of other cytostatics, e.g., anthracyclines. Myocardial ischemia was suggested as potential mechanism due to occasionally observed ECG alterations during 5-FU administration. Experimental studies revealed potential mechanisms of cardiotoxicity ranging from direct toxic effects on vascular endothelium involving endothelial NO synthase leading to coronary spasms and endothelium independent vasoconstriction via protein kinase C. In addition, rheological side effects have to be considered. Coronary artery disease is judged to increase the risk of cardiac side effects. Despite lack of prospective trials, verapamil type calcium antagonists as well as nitrates seem to be useful for treatment of 5-FU induced coronary spasms. In addition, modification of the cytostatic regimen has to be considered in patients who had been symptomatic. It could be assumed that 5-FU toxicity is reversible in the majority of cases when acute complications, e.g., arrhythmias, are resolved.
Export Options
About this article
Cite this article as:
Alter P., Herzum M., Soufi M., Schaefer R. J. and Maisch B., Cardiotoxicity of 5-Fluorouracil, Cardiovascular & Hematological Agents in Medicinal Chemistry 2006; 4 (1) . https://dx.doi.org/10.2174/187152506775268785
DOI https://dx.doi.org/10.2174/187152506775268785 |
Print ISSN 1871-5257 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6182 |
Call for Papers in Thematic Issues
Medicinal Plants with Beneficial Properties on Diabetes and Hypertension
Diabetes and hypertension are real scourges of the 21st century. It is imperative to act in order to find innovative solutions to this problem. Taking medications such as hypoglycemic and antihypertensive drugs may aggravate certain underlying comorbidities, such as chronic kidney disease and cardiovascular disease. This significant drawback therefore requires ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
PREFACE: “The Lower the Better” Association between White-coat Effect-excluded Blood Pressure and Cardiovascular Events in High-risk Hypertension: Insights from SPRINT
Current Hypertension Reviews Imaging Stem Cell Therapy for the Treatment of Peripheral Arterial Disease
Current Vascular Pharmacology Development and Clinical use of Prasugrel and Ticagrelor
Current Pharmaceutical Design Preventive and Therapeutic Role of Muscle Contraction Against Chronic Diseases
Current Pharmaceutical Design Recommendations for the Treatment of Hypertension in Elderly People
Cardiovascular & Hematological Agents in Medicinal Chemistry Non-Cardiomyocytes in Heart Regeneration
Current Drug Targets Prognostic Implications of Genetics in Cardiovascular Disease
Current Pharmacogenomics Microparticles: From Biogenesis to Biomarkers and Diagnostic Tools in Cardiovascular Disease
Current Stem Cell Research & Therapy Platelet Glycoprotein IIb / IIIa Inhibition and its Clinical Use
Current Medicinal Chemistry - Cardiovascular & Hematological Agents Targeting mTOR Signaling in Type 2 Diabetes Mellitus and Diabetes Complications
Current Drug Targets Diabetic Neuropathy: Update on Pathophysiological Mechanism and the Possible Involvement of Glutamate Pathways
Current Diabetes Reviews The Relationship Between HIV Infection and Cardiovascular Disease
Current Cardiology Reviews Biological Importance, Therapeutic Benefit and Analytical Aspects of Bioactive Flavonoid Pectolinarin in the Nature
Drug Metabolism Letters Patent Selections:
Recent Patents on Biomarkers Myocardial Energetics in Left Ventricular Hypertrophy
Current Cardiology Reviews Cardiovascular Effects of Flavonoids
Current Medicinal Chemistry Endothelium as a Therapeutic Target in Diabetes Mellitus: From Basic Mechanisms to Clinical Practice
Current Medicinal Chemistry Therapeutic Application of Endothelial Progenitor Cells for Treatment of Cardiovascular Diseases
Current Stem Cell Research & Therapy Sodium-Proton Exchanger Isoform-1: Synthesis of a Potent Inhibitor Labeled with Deuterium and Carbon-14
Current Radiopharmaceuticals Nanocarriers Assisted siRNA Gene Therapy for the Management of Cardiovascular Disorders
Current Pharmaceutical Design