Ischemic heart disease associated with bortezomib treatment combined with dexamethasone in a patient with multiple myeloma.
A 79-year-old female patient with multiple myeloma who had no prior cardiac disease history developed an acute myocardial infarction on day 5 after receiving bortezomib and dexamethasone (BD). After treatment of coronary stenoses by stents, she received another course of BD therapy and developed angina pectoris on day 5 after the therapy. Bortezomib's antitumor effect is due to the inhibition of proteasome activity. This inhibition may increase endothelial progenitor cell apoptosis and decrease endothelial nitric oxide synthase/nitric oxide (eNOS/NO), thus leading to coronary spasm. It is, therefore, important to carefully monitor patients being treated with bortezomib for the potential occurrence of ischemic heart disease.
Takamatsu
Hiroyuki
H
Department of Internal Medicine, NTT WEST Kanazawa Hospital, 6-26 Shimoshinmachi, Kanazawa, Ishikawa, 920-0910, Japan. takamaz@med3.m.kanazawa-u.ac.jp
Yamashita
Takeshi
T
Kotani
Takeharu
T
Sawazaki
Aiko
A
Okumura
Hirokazu
H
Nakao
Shinji
S
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001897:Boronic Acids / Q000009:adverse effects*; D000069286:Bortezomib; D003331:Coronary Vessels / Q000187:drug effects / Q000473:pathology; D003907:Dexamethasone / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy*; D009203:Myocardial Infarction / Q000139:chemically induced*; D011719:Pyrazines / Q000009:adverse effects*
D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone
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