Two cases of acute myocardial infarction during combined chemotherapy in young patients with testicular cancer

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• 作者：Naoko Kawano ; MD^a ; Koji Yamaguchi ; PhD^b ; ^{yamakoji3@hotmail.com} ; Toshiyuki Niki ; MD^b ; Takashi Yamamoto ; PhD^c ; Takashi Iwase ; PhD^b ; Yoshio Taketani ; MD^b ; Takayuki Ise ; PhD^b ; Hirotsugu Yamada ; PhD^b ; Takeshi Soeki ; PhD ; FJCC^b ; Tetsuzo Wakatsuki ; PhD^b ; Kazuhiro Kawano ; PhD^c ; Akiyoshi Kakutani ; PhD^c ; Masataka Sata ; PhD ; FJCC^b
• 关键词：Acute myocardial infarction ; Combined chemotherapy ; Testicular cancer ; Young age
• 刊名：Journal of Cardiology Cases
• 出版年：2013
• 出版时间：June, 2013
• 年：2013
• 卷：7
• 期：6
• 页码：e176-e180
• 全文大小：1104 K

文摘

The two patients were males aged over 30 years. To treat testicular tumors, combination chemotherapy with bleomycin, etoposide, and cisplatin (BEP) had been employed. In case 1, during the 4th course of BEP therapy, thoracic pain suddenly appeared. Emergency coronary angiography revealed thrombus formation. Under a diagnosis of thrombus-related acute myocardial infarction, thrombus aspiration was conducted, and stent implantation was performed because mild stenosis and residual thrombus were observed. In case 2, during the 2nd course of BEP therapy, thoracic pain suddenly appeared. Emergency coronary angiography revealed thrombus formation. Intracoronary infusion of pro-urokinase was performed, and additional balloon dilatation was conducted because mild stenosis and residual thrombus were observed. In both cases, the courses were favorable, and the levels of coagulation markers on admission were high. When selecting combination chemotherapy in patients with coronary risk factors, such as obesity and smoking, despite a young age, as demonstrated in these two patients, it may be important to consider combination therapy with anticoagulants or switching to anticancer drugs that do not show vascular toxicity.

<Learning objective: When performing combination chemotherapy with bleomycin, etoposide, and cisplatin in young patients with coronary risk factors such as obesity and smoking, it may be important to examine combination therapy with anticoagulants or switching to anticancer drugs that do not show vascular toxicity, considering the possibility of cardiovascular disease onset, including acute myocardial infarction.>