Fruquintinib-induced acute myocardial infarction complicated by heart failure
10.3760/cma.j.cn114015-20240926-00063
- VernacularTitle:呋喹替尼致急性心肌梗死合并心力衰竭
- Author:
Lijuan ZHAO
1
;
Baoqing YAN
1
;
Jianzhou SHAO
1
;
Yupeng LIU
1
Author Information
1. 玲珑英诚医院药学部，烟台 265400
- Publication Type:Journal Article
- Keywords:
Hypertension;
Myocardial infarction;
Heart failure;
Fruquintinib;
Tyrosine kinase inhibitors;
Vascular endothelial growth factor receptors;
Cardiovascular t
- From:
Adverse Drug Reactions Journal
2025;27(6):380-382
- CountryChina
- Language:Chinese
-
Abstract:
A 75-year-old female patient with postoperative colon cancer received fruquintinib (5 mg once daily, 3 weeks on and 1 week off per 4-week cycle). The patient had normal blood pressure in the past, and approximately one week after medication, she developed hypertension with systolic blood pressure 180-190 mmHg and unknown diastolic pressure. The patient′s blood pressure was with adequate control after self-administration of nifedipine sustained-release tablets twice (20 mg/dose). After 3 weeks of fruquintinib treatment, bilateral lower limb edema occurred in the patient, leading to a 1-week drug discontinuation. Upon resuming the medication for 1 day, the patient suddenly developed dyspnea and loss of consciousness. Chest CT revealed signs of heart failure. Laboratory tests showed high-sensitivity cardiac troponin I (hs-cTnI) 0.27 μg/L, creatine kinase (CK)-MB 7.13 μg/L, myoglobin 132.88 μg/L, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) 4 039.8 ng/L. Fruquintinib was discontinued, and the patient received myocardial nutritional support, diuretics, anticoagulants, hepatoprotective agents, and potassium supplementation, etc. On day 2, the patient regained consciousness with hs-cTnI 0.28 μg/L, CK-MB 4.63 μg/L, myoglobin 34.25 μg/L, and NT-proBNP 10 181.3 ng/L. Antiplatelet therapy, diuretics, lipid-lowering agents, and antihypertensive treatment were initiated. On day 3, color doppler echocardiography confirmed myocardial infarction complicated by heart failure. Fruquintinib-induced acute non-ST-segment elevation myocardial infarction with acute heart failure was considered. On day 6 of fruquintinib discontinuation, NT-proBNP decreased to 295.8 ng/L, and all laboratory test parameters normalized on day 9. One month later, repeated tests showed no abnormalities in the myocardial enzyme.
