Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
The role of cardiovascular risk factors in coronary vasospasm with fluoropyrimidines
Session:
Comunicações Orais - Sessão 17 -Síndromes Coronárias Crónicas
Speaker:
Isabel Cardoso
Congress:
CPC 2023
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
12. Coronary Artery Disease (Chronic)
Subtheme:
12.8 Coronary Artery Disease - Other
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Isabel Cardoso; Vera Ferreira; Tânia Mano; Inês Guerreiro; Leonor Fernandes; André Grazina; Sofia Jacinto; Ricardo Carvalheiro; André Ferreira; Pedro Rio; Luís Almeida Morais; Rui Cruz Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Fluoropyrimidines are widely used in the treatment of solid tumours, including adenocarcinomas of gastrointestinal tract, lung and breast. Cardiac toxicity typical presents as chest pain, predominantly caused by vasospasm. The precise role of cardiovascular (CV) risk factors on the risk of coronary vasospasm is yet to be defined. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objectives: </strong>To evaluate the prevalence and risk factors for coronary artery vasospasm in high-risk patients (pts) under treatment with fluoropyrimidines. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> We conducted a retrospective analysis of all pts who received fluoropyrimidines (5-fluorocil and oral pro-drug capecitabine) at a single center cardio oncology clinic, between April 2021 and October 2022. Vasospasm was diagnosed based on the presence of typical <em>de novo </em>chest pain concomitant with treatment with fluoropyrimidines, new ST-segment changes or elevated biomarkers and/or positive intracoronary provocative test and exclusion of coronary artery disease. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> We analysed 41 patients with a median age of 72 (IQR 62-79) years old, mostly males (59%) with a high burden of CV risk factors (49% of the patients had more than 2 CV risk factors), 10 pts (24%) were current smokers (Table 1). 16 Pts (39%) had history of ischemic heart disease. Episodes of non-persistent chest pain were reported in 7 pts (17%), although vasospasm was only confirmed in 2 of these patients (5%) (Table 1). Active smoking was significantly associated with the occurrence of chest pain during treatment (p= 0.047). No association between CV risk factors and vasospasm was found (p=0.67). No association was found between chest pain and use of beta-blockers (p=0.42) or with ischemic heart disease (p=0.69). No difference between the type of drug administered or route of administration (oral capecitabine or 5-fluorocil) and the presence of chest pain was verified (p=0.70). A significant association was found between chest pain and chemotherapy suspension (p=0.01). All patients diagnosed with vasospasm suspended therapy. Mortality during follow-up was 12%. Mortality was associated in 80% of the patients to progression of oncological disease, no deaths were attributed to cardiovascular events. </span></span></p> <p><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Conclusion: </span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">In our cohort of high-risk cardiovascular patients under fluoropyrimidine treatment, the prevalence of de novo chest pain was 17%, while, coronary vasospasm occurred only in 5%. These patients need a precise evaluation with tailored made decisions, because, as we proved, presenting de novo chest pain has major clinical impact leading to chemotherapy suspension. Active smoking was identified as a risk factor for chest pain during treatment.</span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site