Department of Internal Medicine, NTT WEST Kanazawa Hospital, 6-26 Shimoshinmachi, Kanazawa, Ishikawa, 920-0910, Japan.
Int J Hematol. 2010 Jun;91(5):903-6. doi: 10.1007/s12185-010-0586-9. Epub 2010 May 11.
A 79-year-old female patient with multiple myeloma who had no prior cardiac disease history developed an acute myocardial infarction on day 5 after receiving bortezomib and dexamethasone (BD). After treatment of coronary stenoses by stents, she received another course of BD therapy and developed angina pectoris on day 5 after the therapy. Bortezomib's antitumor effect is due to the inhibition of proteasome activity. This inhibition may increase endothelial progenitor cell apoptosis and decrease endothelial nitric oxide synthase/nitric oxide (eNOS/NO), thus leading to coronary spasm. It is, therefore, important to carefully monitor patients being treated with bortezomib for the potential occurrence of ischemic heart disease.
一位 79 岁女性多发性骨髓瘤患者，无既往心脏病史，在接受硼替佐米和地塞米松（BD）治疗 5 天后发生急性心肌梗死。经支架治疗冠脉狭窄后，她又接受了一个疗程的 BD 治疗，在治疗后第 5 天出现心绞痛。硼替佐米的抗肿瘤作用是由于抑制蛋白酶体活性。这种抑制可能会增加内皮祖细胞凋亡，减少内皮型一氧化氮合酶/一氧化氮（eNOS/NO），从而导致冠状动脉痉挛。因此，在使用硼替佐米治疗时，仔细监测患者是否有发生缺血性心脏病的潜在风险非常重要。
