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Symptomatic Cardiotoxicity Associated with 5‐Fluorouracil
Author(s) -
Meyer Christine C.,
Calis Karim Anton,
Burke Laurie B.,
Walawander Cynthia A.,
Grasela Thaddeus H.
Publication year - 1997
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1997.tb03748.x
Subject(s) - cardiotoxicity , medicine , fluorouracil , concomitant , prospective cohort study , incidence (geometry) , etoposide , heart disease , chemotherapy , physics , optics
A prospective cohort study was conducted in 35 hospitals with oncology units to determine the incidence of symptomatic cardiotoxicity in patients receiving continuous infusions of 5‐fluorouracil (5‐FU), and to identify risk factors that could contribute to the development of 5‐FU‐associated cardiotoxicity. A sample of 483 patients [197 (41%) women, overall average age ± SD 60.9 ± 11.9 yrs] were followed for one cycle of 5‐FU infusion. Thirty‐eight (7.9%) patients had abrupt termination of the infusion. There were 9 (1.9%) cases of suspected or documented cardiotoxic events. Cardiotoxicity occurred in 7 (3.35%) of 209 patients receiving their first course of 5‐FU and in 2 (0.73%) other patients (p=0.044). Based on univariate analysis, the following patient groups were at elevated risk of cardiotoxicity: those with preexisting cardiac disease (RR=6.83, p=0.0023); patients receiving calcium channel blockers (RR=4.75, p=0.014); those receiving nitrates (RR=9.18, p=0.007); and patients receiving concomitant etoposide (RR=10.32, p=0.022). Patients with underlying cardiac disease require close monitoring while receiving continuous infusions of 5‐FU. They should be observed for signs and symptoms of cardiotoxicity, and vital signs should be measured frequently. Continued reporting of 5‐FU‐associated cardiotoxicity is necessary to identify other patients at risk.