Prunier F, Monségu J, Coutant G, Ollivier J P
Service de pathologie cardiovasculaire, hôpital d'instruction des armées du Val-de-Grâce, Paris, France.
Rev Med Interne. 2000 May;21(5):439-44. doi: 10.1016/s0248-8663(00)88955-9.
The incidence of cardiac toxicity due to 5-fluorouracil (5-FU) ranges from 1.2 to 18%. Most complications occur at the time of the first cure. Their mechanisms have not yet been clearly defined.
The authors report a case of unstable angina induced by 5-FU. A coronary angioplasty was performed on a previously ignored coronary lesion.
Recent studies support the hypothesis that 5-FU has endothelial toxicity resulting in thrombogenic effect and release of vasoactive substances. Unstable angina pectoris would be related to plaque rupture caused by 5-FU. Patients with previous history of coronary disease are at significantly increased risk for 5-FU-induced cardiotoxicity. They probably would benefit from continuous electrocardiographic monitoring. Rechallenge with 5-FU after cardiotoxicity problems should include only those patients for whom there is no alternative treatment.
5-氟尿嘧啶（5-FU）所致心脏毒性的发生率为1.2%至18%。多数并发症发生在首次治疗期间。其机制尚未明确。
作者报告1例由5-FU诱发的不稳定型心绞痛病例。对一处先前被忽视的冠状动脉病变进行了冠状动脉血管成形术。
近期研究支持如下假说，即5-FU具有内皮毒性，可导致血栓形成效应及血管活性物质释放。不稳定型心绞痛可能与5-FU所致斑块破裂有关。有冠心病既往史的患者发生5-FU所致心脏毒性的风险显著增加。他们可能受益于持续心电图监测。出现心脏毒性问题后再次使用5-FU应仅限于无替代治疗方案的患者。
