Emergency coronary angioplasty following treatment with 5-fluorouracil.

Introduction, - The incidence of cardiac toxicity due to 5-fluorouracil (5- FU) ranges from 1.2 to 18%. Most complications occur at the time of the fir st cure. Their mechanisms have not yet been clearly defined. Exegesis, - The authors report a case of unstable angina induced by 5-FU. A coronary angioplasty was performed on a previously ignored coronary lesion . Conclusion. - Recent studies support the hypothesis that 5-FU has endotheli al toxicity resulting in thrombogenic effect and release of vasoactive subs tances. Unstable angina pectoris would be related to plaque rupture caused by 5-FU. Patients with previous history of coronary disease are at signific antly increased risk for 5-FU-induced cardiotoxicity. They probably would b enefit from continuous electrocardiographic monitoring. Rechallenge with 5- FU after cardiotoxicity problems should include only those patients for who m there is no alternative treatment (C) 2000 Editions scientifiques et medi cales Elsevier SAS.