Rodriguez-Ziccardi Mary, Rubio Manolo, Lu Marvin, Greenspan Allan
Internal Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Division of Cardiac Electrophysiology, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
BMJ Case Rep. 2018 Feb 8;2018:bcr-2017-220723. doi: 10.1136/bcr-2017-220723.
Anagrelide is a phosphodiesterase-3 inhibitor used in the treatment of essential thrombocythaemia. Cardiovascular side effects such as ventricular tachycardia and cardiomyopathy are rare but potentially fatal and should be made known to patients before starting the medication. It usually arises within the first 6 months after initiation of therapy and may be dose related. The elderly population are particularly susceptible. These cardiotoxicities result from an increase in cyclic AMP that induces positive inotropic and chronotropic effects and are often reversible with cessation of use. We report a case of a 78-year-old woman with essential thrombocythaemia and recently started on anagrelide who presented with syncope and multiple bruises and facial trauma and found to have developed ventricular tachyarrhythmia.
阿那格雷是一种用于治疗原发性血小板增多症的磷酸二酯酶-3抑制剂。心血管副作用如室性心动过速和心肌病虽罕见但可能致命,在开始用药前应告知患者。其通常在治疗开始后的前6个月内出现,可能与剂量有关。老年人群尤其易感。这些心脏毒性是由环磷酸腺苷增加导致的,会引起正性肌力和变时性作用,停药后通常可逆转。我们报告一例78岁患有原发性血小板增多症且最近开始服用阿那格雷的女性病例,该患者出现晕厥、多处瘀伤和面部创伤,经检查发现已发生室性快速心律失常。