Ottervanger J P, Wilson J H, Stricker B H
Department of Internal Medicine II, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Eur J Clin Pharmacol. 1997;53(2):105-10. doi: 10.1007/s002280050346.
To analyse reports of drug-induced myocardial infarction and chest pain sent to a national reporting centre. To review which drugs were suspected of exhibiting these adverse events and what mechanisms were involved.
During the 20-year period 1975 through 1994, a total of 19,141 reports on adverse reactions to drugs were received by the Netherlands Centre for Monitoring of Adverse Reactions to Drugs. Of these 19,141 reports, 220 (1.1%) were concerned with drug-induced chest pain or myocardial infarction. After excluding reports in which the causal relationship was unlikely, poorly documented reports and reports on cases of overdosage, 183 reports (84%) were analysed.
There were 130 reports (71%) of drug-induced chest pain and 53 reports (29%) of drug-induced myocardial infarction. A total of 104 reports concerned females (57%). The most frequently reported suspected drugs were the antimigraine drug sumatriptan (33 reports, 4 concerning myocardial infarction), the calcium antagonist nifedipin (9 reports, 2 of myocardial infarction) and nicotine [9 reports (8 patches, 1 chewing gum), 5 concerning myocardial infarction]. There were 18 reports of a fatal outcome.
Several drugs can produce chest pain or myocardial ischaemia. It is important to recognise drugs as a potential cause, especially in patients with normal coronary arteries.
分析发送至国家报告中心的药物性心肌梗死和胸痛报告。回顾哪些药物被怀疑引发了这些不良事件以及涉及哪些机制。
在1975年至1994年的20年期间，荷兰药物不良反应监测中心共收到19141份药物不良反应报告。在这19141份报告中，220份（1.1%）涉及药物性胸痛或心肌梗死。排除因果关系不太可能、记录不充分的报告以及过量用药病例报告后，对183份报告（84%）进行了分析。
有130份（71%）药物性胸痛报告和53份（29%）药物性心肌梗死报告。共有104份报告涉及女性（57%）。报告中最常被怀疑的药物是抗偏头痛药物舒马曲坦（33份报告，4份涉及心肌梗死）、钙拮抗剂硝苯地平（9份报告，2份涉及心肌梗死）和尼古丁[9份报告（8份为贴片，1份为口香糖），5份涉及心肌梗死]。有18份报告出现了致命结局。
几种药物可导致胸痛或心肌缺血。认识到药物是潜在病因很重要，尤其是在冠状动脉正常的患者中。
