Nykamp Diane L, Fackih Majed N, Compton Anthony L
Department of Clinical and Administrative Services, School of Pharmacy, Mercer University, Atlanta, GA 30341-4155, USA.
Ann Pharmacother. 2004 May;38(5):812-6. doi: 10.1345/aph.1D473. Epub 2004 Mar 16.
To report a possible incidence of acute lateral-wall myocardial infarction (MI) coinciding with the use of a Citrus aurantium L. (bitter orange)-containing dietary supplement in a patient with undetected coronary vascular disease.
A 55-year-old white woman presented to the emergency department with symptoms of dull aching shoulder and chest pain. A review of medications during cardiac rehabilitation revealed the patient had ingested a multicomponent dietary supplement for weight loss containing 300 mg of bitter orange (Edita's Skinny Pill) for the past year. Although the patient's past medical history did not include hypertension, coronary disease, or hyperlipidemia, an arteriogram revealed a lesion in the left main coronary artery. She did have a smoking history. She was diagnosed with acute lateral-wall MI and hospitalized for 4 days.
Consumers generally consider dietary supplements safe. However, some supplements taken for weight loss contain ingredients that have been associated with cardiovascular events. Although consumers are becoming more aware of the serious adverse effects secondary to products containing ingredients such as Ma huang and ephedra, reports involving other ingredients are increasing. Bitter orange or synephrine, found in bitter orange, has been associated with adverse cardiovascular reactions. Based on the Naranjo probability scale, C. aurantium is possibly associated with this cardiovascular event.
The use of C. aurantium-containing supplements may present as a risk for cardiovascular toxicity; however, additional studies/case reports are needed to validate this conclusion.
报告一名未被检测出患有冠状动脉疾病的患者在使用含酸橙（苦橙）的膳食补充剂时可能并发急性侧壁心肌梗死（MI）的病例。
一名55岁的白人女性因肩部钝痛和胸痛症状前往急诊科就诊。对其心脏康复期间的用药情况进行回顾发现，该患者在过去一年中摄入了一种含有300毫克苦橙（伊迪塔减肥丸）的多成分减肥膳食补充剂。尽管该患者既往病史中不包括高血压、冠状动脉疾病或高脂血症，但血管造影显示左主干冠状动脉有病变。她有吸烟史。她被诊断为急性侧壁心肌梗死并住院4天。
消费者通常认为膳食补充剂是安全的。然而，一些用于减肥的补充剂含有与心血管事件相关的成分。尽管消费者越来越意识到含有麻黄和麻黄碱等成分的产品会产生严重的不良反应，但涉及其他成分的报告也在增加。苦橙中含有的苦橙或辛弗林已与不良心血管反应相关。根据纳伦霍概率量表，酸橙可能与这一心血管事件有关。
使用含酸橙的补充剂可能存在心血管毒性风险；然而，需要更多的研究/病例报告来证实这一结论。
