PMID- 18843078
OWN - NLM
STAT- MEDLINE
DCOM- 20090203
LR  - 20151119
IS  - 1472-0213 (Electronic)
IS  - 1472-0205 (Linking)
VI  - 25
IP  - 10
DP  - 2008 Oct
TI  - Coronary spasm induced by capecitabine mimicks ST elevation myocardial 
      infarction.
PG  - 699-700
LID - 10.1136/emj.2008.060574 [doi]
AB  - Capecitabine is a chemotherapeutic prodrug that is metabolised to 5-fluorouracil. 
      Supported by the National Institute for Health and Clinical Excellence guidance 
      it is now first-line adjuvant treatment for metastatic colorectal cancer in the 
      UK. Although cardiac chest pain and myocardial ischaemia are well recognised side 
      effects of 5-fluorouracil, their association with capecitabine is not widely 
      appreciated. Two cases are described of coronary spasm secondary to capecitabine 
      in patients referred for emergency invasive treatment of presumed ST elevation 
      myocardial infarction (STEMI). The contemporary treatment of acute coronary 
      syndromes involves aggressive antiplatelet therapy, anticoagulation and cardiac 
      catheterisation. This treatment, although beneficial in most patients, is 
      associated with a small but significant risk of bleeding complications. A wider 
      appreciation of the potential for capecitabine to induce spasm mimicking STEMI is 
      important in order to reduce the risk of the administration of thrombolytics and 
      other potentially dangerous drugs and have a higher threshold for referral for 
      emergency angiography.
FAU - Scott, P A
AU  - Scott PA
AD  - Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO166YD, 
      UK.
FAU - Ferchow, L
AU  - Ferchow L
FAU - Hobson, A
AU  - Hobson A
FAU - Curzen, N P
AU  - Curzen NP
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - England
TA  - Emerg Med J
JT  - Emergency medicine journal : EMJ
JID - 100963089
RN  - 0 (Antimetabolites, Antineoplastic)
RN  - 0W860991D6 (Deoxycytidine)
RN  - 6804DJ8Z9U (Capecitabine)
RN  - U3P01618RT (Fluorouracil)
SB  - IM
MH  - Aged
MH  - Antimetabolites, Antineoplastic/*adverse effects/therapeutic use
MH  - Capecitabine
MH  - Chest Pain/*chemically induced
MH  - Colorectal Neoplasms/drug therapy
MH  - Coronary Vasospasm/*chemically induced
MH  - Deoxycytidine/adverse effects/*analogs & derivatives/therapeutic use
MH  - Diagnosis, Differential
MH  - Electrocardiography
MH  - Fluorouracil/adverse effects/*analogs & derivatives/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2008/10/10 09:00
MHDA- 2009/02/04 09:00
CRDT- 2008/10/10 09:00
PHST- 2008/10/10 09:00 [pubmed]
PHST- 2009/02/04 09:00 [medline]
PHST- 2008/10/10 09:00 [entrez]
AID - 25/10/699 [pii]
AID - 10.1136/emj.2008.060574 [doi]
PST - ppublish
SO  - Emerg Med J. 2008 Oct;25(10):699-700. doi: 10.1136/emj.2008.060574.