Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Korean Circ J. 2009 Mar;39(3):124-7. doi: 10.4070/kcj.2009.39.3.124. Epub 2009 Mar 25.
A 63-year-old woman was diagnosed with ovarian cancer and peritoneal carcinomatosis. The day after paclitaxel was administered, an acute myocardial infarction occurred. Emergency coronary angiography revealed a filling defect in the left main coronary artery and total occlusion in the distal left anterior descending coronary artery, with no luminal irregularity or narrowing. Intravascular ultrasonography showed no significant plaque in the left main coronary artery. A thrombophilia work-up was negative, and the patient was treated with tirofiban, clopidogrel, and aspirin. The follow-up coronary angiogram showed that the occlusion of the distal obtuse marginal branch and distal left anterior descending artery had cleared. Paclitaxel has been associated with acute myocardial infarction. However, the pathogenesis of myocardial infarction associated with paclitaxel is not known. This case raises the possibility that paclitaxel can induce coronary artery thrombosis, resulting in myocardial infarction.
一位 63 岁女性被诊断患有卵巢癌和腹膜癌病。紫杉醇给药的第二天，发生急性心肌梗死。紧急冠状动脉造影显示左主干冠状动脉充盈缺损和左前降支远段完全闭塞，管腔无不规则或狭窄。血管内超声检查显示左主干冠状动脉无明显斑块。血栓形成倾向检查为阴性，患者接受替罗非班、氯吡格雷和阿司匹林治疗。随访冠状动脉造影显示，钝缘支远段和左前降支远段闭塞已清除。紫杉醇与急性心肌梗死有关。然而，紫杉醇相关心肌梗死的发病机制尚不清楚。本例提示紫杉醇可能诱导冠状动脉血栓形成，导致心肌梗死。
