Heart failure caused by palbociclib capsules combined with fulvestrant injection
10.3760/cma.j.cn114015-20220421-00344
- VernacularTitle:哌柏西利胶囊与氟维司群注射液联用致心力衰竭
- Author:
Jiajia LIU
1
;
Guilin HE
;
Yuanyuan WANG
;
Min MAO
Author Information
1. 河北省眼科医院药剂科，邢台 054001
- Publication Type:Journal Article
- Keywords:
Palbociclib;
Fulvestrant;
Heart failure;
Ejection fraction;
Cardiotoxicity
- From:
Adverse Drug Reactions Journal
2023;25(1):59-61
- CountryChina
- Language:Chinese
-
Abstract:
A 68-year-old female patient with breast cancer and lung metastasis received fulvestrant injection (fulvestrant) 0.5 g intramuscularly on day 1, and palbociclib capsules (palbociclib) 75 mg once daily orally for 21 days with a 7-day interval; 28 days was a cycle. Before treatments, laboratory test showed brain natriuretic peptide 811.3 ng/L and the electrocardiogram showed no obvious abnormality. During the 7th treatment cycle, the patient developed dyspnea after climbing stairs, accompanied by chest pain, chest tightness, and palpitations. N-terminal pro-brain natriuretic peptido (NT-proBNP) was 4 001 ng/L. Echocardiography showed that the left ventricular ejection fraction (LVEF) was 25%, the left ventricular wall motion was generally weakened, the left ventricle was enlarged, and the left ventricular systolic and diastolic functions were reduced. Electrocardiogram showed sinus tachycardia and ST-T changes. Heart failure with reduced ejection fraction caused by fluvestrant and palbociclib was considered. The 2 drugs were discontinued and anti-heart failure therapy including sacubitril valsartan, torasemide, and metoprolol succinate was given for 40 days. The patient′s dyspnea and chest tightness were improved. Laboratory test showed NT-proBNP 4 345 ng/L, echocardiography showed LVEF 26%, and coronary angiography showed no stenosis. Coronary artery disease was excluded, and chronic heart failure was diagnosed, with cardiac function of grade Ⅲ. After implanting the implantable cardioverter defibrillator and continuing the anti-heart failure drug treatment for 24 days, NT-proBNP decreased to 2 321 ng/L, LVEF was 25%, and cardiac function was grade Ⅰ-Ⅱ.
