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Review
. 2019 Nov;37(4):399-405.
doi: 10.1016/j.ccl.2019.07.004. Epub 2019 Aug 26.

Fluoropyrimidine-Associated Cardiotoxicity

Jaya Kanduri  1 , Luis Alberto More  2 , Anuradha Godishala  3 , Aarti Asnani  4
Affiliations
Review

Fluoropyrimidine-Associated Cardiotoxicity

Jaya Kanduri et al. Cardiol Clin. 2019 Nov.

Abstract

Fluoropyrimidines are chemotherapeutic agents that confer great benefit to many patients with solid tumors, but their use is often limited by cardiotoxicity. The incidence and precise mechanisms of cardiotoxicity remain uncertain. Clinical presentations of fluoropyrimidine toxicity are varied and include chest pain, myocardial infarction, acute cardiomyopathy, arrhythmia, cardiogenic shock, and sudden cardiac death. Proposed mechanisms include coronary vasospasm, coronary endothelial dysfunction, direct myocardial toxicity, myocarditis, and Takotsubo cardiomyopathy. Therapeutic and prophylactic interventions primarily target coronary vasospasm as the underlying cause. Prospective studies are needed to develop evidence-based approaches to cardioprotection in patients receiving fluoropyrimidines.

Keywords: 5-FU; Capecitabine; Cardiotoxicity; Chemotherapy; Coronary vasospasm; Fluoropyrimidines.

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