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🌱 來自: AEs of Fluorouracil

coronary artery vasospasm

• The underlying mechanism of coronary vasospasm is → likely the result of

  • endothelial dysfunction
  • caused by 5-FU and its active metabolites.

• Endothelial dysfunction is → thought to be due to an increase in the release of

  • endothelin-1, a vasoconstrictor,
  • decrease in the release of prostacyclin, a vasodilatator

• 5-FU-Associated Coronary Vasospasm: Who is → Really at ↣ Risk? - American College of Cardiology

• In the largest single-center retrospective cohort of 5-fluorouracil (5-FU) associated coronary vasospasm,

  • younger patients with lower rates of baseline cardiovascular risk factors were at ↣ a higher risk of developing coronary vasospasm.

• The 5-FU dose received by patients with vasospasm was significantly lower than that for patients without vasospasm;

  • however, there was no significant difference in progression-free or overall survival among patients with coronary vasospasm compared with those who did not develop vasospasm.

• Younger patients may require closer monitoring

  • and lower threshold for workup of any chest discomfort in the setting of 5-FU therapy.