Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan.
Department of Hematology, Chiba University Hospital, Japan.
Intern Med. 2022 Nov 1;61(21):3293-3299. doi: 10.2169/internalmedicine.9090-21. Epub 2022 Mar 26.
Anagrelide is used worldwide to treat essential thrombocythemia (ET) by reducing platelet counts. Cardiomyopathy and heart failure (HF) are rare but serious complications associated with anagrelide use, although no cases were reported during Japanese Phase I to III studies. A 46-year-old, otherwise healthy, Japanese ET patient developed HF with reduced ejection fraction after 18 months of treatment with 1.0-3.5 mg of anagrelide daily. HF was stabilized with anagrelide withdrawal and guideline-directed HF therapy. The cardiac function returned to normal after six months. This case suggests that anagrelide can cause cardiomyopathy and HF in ET patients, regardless of nationality, comorbid cardiovascular conditions, or therapy duration.
氨甲环酸被广泛用于通过降低血小板计数来治疗特发性血小板增多症（ET）。尽管在日本的 I 期至 III 期研究中没有报告病例，但心肌病和心力衰竭（HF）是与氨甲环酸使用相关的罕见但严重的并发症。一名 46 岁的、无其他疾病的日本 ET 患者在每天服用 1.0-3.5 毫克氨甲环酸治疗 18 个月后，出现射血分数降低性心力衰竭（HF）。通过停用氨甲环酸和遵循心力衰竭治疗指南，HF 得到稳定。六个月后，心脏功能恢复正常。该病例表明，氨甲环酸可导致 ET 患者发生心肌病和 HF，无论患者的国籍、合并心血管疾病状况或治疗持续时间如何。
