[Emergency coronary angioplasty following treatment with 5-fluorouracil].
BACKGROUND
The incidence of cardiac toxicity due to 5-fluorouracil (5-FU) ranges from 1.2 to 18%. Most complications occur at the time of the first cure. Their mechanisms have not yet been clearly defined.


METHODS
The authors report a case of unstable angina induced by 5-FU. A coronary angioplasty was performed on a previously ignored coronary lesion.


CONCLUSIONS
Recent studies support the hypothesis that 5-FU has endothelial toxicity resulting in thrombogenic effect and release of vasoactive substances. Unstable angina pectoris would be related to plaque rupture caused by 5-FU. Patients with previous history of coronary disease are at significantly increased risk for 5-FU-induced cardiotoxicity. They probably would benefit from continuous electrocardiographic monitoring. Rechallenge with 5-FU after cardiotoxicity problems should include only those patients for whom there is no alternative treatment.
Prunier
F
F
Service de pathologie cardiovasculaire, hôpital d'instruction des armées du Val-de-Grâce, Paris, France.
Monségu
J
J
Coutant
G
G
Ollivier
J P
JP
D000368:Aged; D000789:Angina, Unstable / Q000139:chemically induced / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003327:Coronary Disease / Q000139:chemically induced / Q000628:therapy*; D004562:Electrocardiography; D004630:Emergencies; D005472:Fluorouracil / Q000009:adverse effects*; D006801:Humans; D008297:Male; D012307:Risk Factors
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil
Angioplastie coronaire en urgence au décours d'une cure de 5-fluoro-uracile.