Cardiotoxicity of 5‐fluorouracil and capecitabine in Chinese patients: a prospective study

• DOI: 10.1186/s40880-018-0292-1
• Publication Date: 2018-05-11T14:06:32Z
• Authors: Jianjun Peng; Chao Dong; Chang Wang; Weihua Li; Hao Yu; Min Zhang; Qun Zhao; Bo Zhu; Jun Zhang; Wenliang Li; Fenghua Wang; Qiong Wu; Wenhao Zhou; Ying Yuan; Meng Qiu; Gong Chen
• Keywords: Cardiotoxicity

Abstract Background 5‐Fluorouracil (5‐FU) and capecitabine‐associated cardiotoxicity ranging from asymptomatic electrocardiography (ECG) abnormalities to severe myocardial infarction has been reported in a number of studies, but such Chinese patients with malignant diseases not investigated date. In the present study, we aimed prospectively evaluate incidence rates clinical manifestations 5‐FU‐ cancer recruited multiple centers China. Methods Among 527 who completed 196 received 5‐FU‐based chemotherapy 331 capecitabine‐based as either first‐line or adjuvant therapy. Adverse events were during treatment up 28 days follow‐up. Outcome measures included ECG, enzymes, cardiac troponin, brain natriuretic peptide echocardiography. Univariate analysis logistic regression performed for subgroup identification significant independent variables that are associated both agents. Results total, 161 (30.6%) experienced cardiotoxicity. The rate was 33.8% (112/331) capecitabine group, which significantly higher than 25% (49/196) 5‐FU group ( P = 0.0042). 110/527 (20.9%) suffered arrhythmia, 105/527 (19.9%) developed ischemic changes, while only 20/527 (3.8%) presented heart failure 6/527 (1.1%) had infarction. Pre‐existing disease, hypertension, duration identified risk factors odds ratio 15.7 (prior history disease versus no history), 1.86 (capecitabine 5‐FU), 1.06 (5–8 1–4 cycles) 1.58 (hypertension hypertension), respectively. Conclusions Cardiotoxicity induced by fluoropyrimidines population may be underestimated practice. Close monitoring is recommended, especially those at high Possible treatment, chemotherapy, pre‐existing hypertension. Trial registration This study initiated on January 22, 2014 retrospectively registered ChiCTR1800015434