Sestito Alfonso, Sgueglia Gregory Angelo, Pozzo Carmelo, Cassano Alessandra, Barone Carlo, Crea Filippo, Lanza Gaetano Antonio
Institutes of Internal Medicine/Oncology, Università Cattolica del Sacro-Cuore, Rome, Italy.
J Cardiovasc Med (Hagerstown). 2006 Feb;7(2):136-8. doi: 10.2459/01.JCM.0000199785.94760.50.
Capecitabine is a new chemotherapeutic agent considered highly specific for sensitive tumour cells, which convert the drug to 5-fluorouracil. Capecitabine is administered on an ambulatory basis for the treatment of metastatic breast and colorectal cancer, and both general practitioners and specialists are likely to deal with patients treated with this drug. We describe the case of a 44-year-old woman, with no cardiovascular risk factors, who started therapy with capecitabine for relapsing of breast carcinoma. She subsequently developed effort angina. Standard electrocardiogram and echocardiography were normal, whereas ST-segment elevation and angina were induced during exercise stress test. Capecitabine was withdrawn and therapy with diltiazem and transdermal nitroglycerine was started. The patient became asymptomatic and repeated symptom-limited exercise stress test did not induce any ST-segment changes or angina, even after withdrawal of anti-ischaemic therapy, thus confirming the hypothesis of capecitabine-induced coronary artery spasm as the cause of patient's symptoms.
卡培他滨是一种新型化疗药物，被认为对敏感肿瘤细胞具有高度特异性，该药物可转化为5-氟尿嘧啶。卡培他滨以门诊给药的方式用于治疗转移性乳腺癌和结直肠癌，全科医生和专科医生都可能会接诊接受这种药物治疗的患者。我们描述了一名44岁女性的病例，她没有心血管危险因素，因乳腺癌复发开始接受卡培他滨治疗。随后她出现了劳力性心绞痛。标准心电图和超声心动图检查正常，但运动负荷试验时诱发了ST段抬高和心绞痛。停用卡培他滨后开始使用地尔硫䓬和硝酸甘油透皮贴剂治疗。患者症状消失，重复进行症状限制性运动负荷试验时，即使停用抗缺血治疗后也未诱发任何ST段改变或心绞痛，从而证实了卡培他滨诱发冠状动脉痉挛是患者症状原因的假设。
