Abstract
IntroductionOral capecitabine is an oral prodrug of 5-fluorouracil that has been integrated into the management of multiple cancer types because of the convenience of administration and its efficacy compared with 5-fluorouracil. Capecitabine mimics the pharmacokinetics of intravenous 5-fluorouracil. While cardiac events associated with the use of 5-fluorouracil are a well-known side effect, capecitabine-induced cardiotoxicity has only been rarely reported.Case presentationWe present a case of a 46-year-old woman of Greek ethnicity who presented to our institution with an operated gastric sarcoma who experienced capecitabine-induced vasospastic angina. Primarily a clinical diagnosis of a possible acute coronary syndrome was proposed and the patient was admitted to the hospital for further investigation which was proved between normal limits. After a witnessed episode of angina, her prior history of capecitabine intake and an undertaken further imaging investigation we associated anginal symptoms and signs with vasospastic angina induced by capecitabine 36 hours prior to hospital admission.ConclusionCardiologists should be aware of the potential cardiac hazards of capecitabine, especially in patients with cardiovascular risk factors. Due to the increasing usage of capecitabine during the last years, patients should be warned for the possibility of chest pain, particularly during the first few days of capecitabine treatment. Specifically, patients developing acute coronary syndrome should not be retreated with capecitabine. On the other hand, due to its promising antitumoral efficacy, its use should not be discouraged.
Highlights
Oral capecitabine is an oral prodrug of 5-fluorouracil that has been integrated into the management of multiple cancer types because of the convenience of administration and its efficacy compared with 5-fluorouracil
Cardiologists should be aware of the potential cardiac hazards of capecitabine, especially in patients with cardiovascular risk factors
Due to the increasing usage of capecitabine during the last years, patients should be warned for the possibility of chest pain, during the first few days of capecitabine treatment
Summary
Capecitabine should be considered a drug with cardiotoxic potential [14], even in the absence of prior cardiac history It can induce coronary spasm at the macro- or microvascular level [15]. Authors’ contributions CGo made substantial contributions to the conception and design of this report, drafting the manuscript and revising it critically He gave final approval of the version to be published. GD made substantial contributions to the conception of this report, drafting the manuscript and revising it critically and analyzing and interpreting echocardiographic data. KC made substantial contribution to the conception and design of this report; acquisition, analysis and interpretation of data He was involved in revising the manuscript critically and gave final approval of the version to be published. University of Thrace, Panepistimioupoli, Dragana 68100 Alexandroupolis, Greece. 2Department of Cardiology, Serres State Hospital, 2nd km E.O Serrwn-Dramas, Serres 62100 Greece. 3Department of Cardiology, Preveza State Hospital, Selefkias 2, Preveza 48100 Greece. 4Department of Interventional Cardiology, Kyanous Stavros Hospital, Vizyis-Vyzantos 1, Thessaloniki 54636 Greece
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
