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. 2020 Mar;25(3):e606-e609.
doi: 10.1634/theoncologist.2019-0762. Epub 2019 Dec 16.

Fluoropyrimidine-Associated Cardiotoxicity: A Retrospective Case-Control Study

Inbar Raber  1 , Sarah Warack  2 , Jaya Kanduri  1 , Abby Pribish  1 , Anuradha Godishala  3 , Arielle Abovich  3 , Anna Orbite  2 , Sujithraj Dommaraju  3 , Morgan Frazer  2 , Mary Linton Peters  4 , Aarti Asnani  3
Affiliations

Fluoropyrimidine-Associated Cardiotoxicity: A Retrospective Case-Control Study

Inbar Raber et al. Oncologist. 2020 Mar.

Abstract

Background: The fluoropyrimidines, 5-fluorouracil (5-FU) and capecitabine, are commonly used chemotherapeutic agents that have been associated with coronary vasospasm.

Methods: In this retrospective case-control study, we identified patients at our institution who received 5-FU or capecitabine in 2018. We compared characteristics of patients who experienced cardiotoxicity with controls. We described phenotypes and outcomes of cardiotoxic cases.

Results: We identified 177 patients who received fluoropyrimidines. After adjudication, 4.5% of the cohort met the criteria for cardiovascular toxicity. Coronary artery disease was more common among cases than controls (38% vs. 7%, p < .05). There was also a trend toward increased prevalence of cardiovascular risk factors in cases compared with controls. Most cardiotoxic cases had chest pain, although a minority of cases presented with nonischemic cardiomyopathy.

Conclusion: Cardiotoxicity phenotypes associated with fluoropyrimidine use are not limited to coronary vasospasm. Cardiac risk factors and ischemic heart disease were highly prevalent among patients with cardiotoxicity.

Keywords: Capecitabine; Cardiotoxicity; Fluorouracil.

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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

Comment in

  • Fluoropyrimidine-Associated Cardiotoxicity: Probably Not So Rare As It Seems.
    Lestuzzi C, Tartuferi L, Viel E, Buonadonna A, Vaccher E, Berretta M. Lestuzzi C, et al. Oncologist. 2020 Aug;25(8):e1254. doi: 10.1634/theoncologist.2020-0053. Epub 2020 Jun 17. Oncologist. 2020. PMID: 32436298 Free PMC article.
  • In Reply.
    Raber I, Peters ML, Asnani A. Raber I, et al. Oncologist. 2020 Aug;25(8):e1255-e1256. doi: 10.1634/theoncologist.2020-0119. Epub 2020 Jun 17. Oncologist. 2020. PMID: 32436313 Free PMC article.

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