title: Acute myocardial infarction after capecitabine treatment: not always vasospasm is responsible.
abstract: Capecitabine is an orally available chemotherapeutic agent that is converted to 5-fluorouracil (5-FU) after absorbtion. Capecitabine and its active metabolite, 5-FU, have cardiotoxic effects with reported instances of acute coronary syndromes caused due to coronary vasospasm. However, these agents exert toxic effects on cardiovascular system and beyond vasospasm provacation. We report a 46-year-old patient diagnosed as acute inferior infarction who is treated with capecitabine for 3 months due to metastatic breast carcinoma, in whom thrombotic coronary occlusion was observed in angiography. This case demonstrates that apart from vasospasm, coronary thrombosis could be observed after capecitabine treatment, with a possible direct effect of this drug.
authors.affiliation: Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey. tsguvenc@gmail.com
authors.forename: Tolga Sinan
authors.initials: TS
authors.lastname: Güvenç
authors.forename: Emel
authors.initials: E
authors.lastname: Celiker
authors.forename: Kazim Serhan
authors.initials: KS
authors.lastname: Ozcan
authors.forename: Erkan
authors.initials: E
authors.lastname: Ilhan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
mesh_terms: D000069287:Capecitabine; D003328:Coronary Thrombosis / Q000139:chemically induced; D003329:Coronary Vasospasm / Q000139:chemically induced*; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced*
chemical_list: D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil