Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2019; 7(1): 89-94
Published online Jan 6, 2019. doi: 10.12998/wjcc.v7.i1.89
Tegafur deteriorates established cardiovascular atherosclerosis in colon cancer: A case report and review of the literature
Shi-Chang Zhang, Meng-Yao Yu, Lei Xi, Jie-Xin Zhang
Shi-Chang Zhang, Meng-Yao Yu, Jie-Xin Zhang, Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Lei Xi, Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Yu MY and Xi L participated in data collection; Zhang SC and Zhang JX conceived and coordinated the study; all authors participated in manuscript writing.
Supported by National Natural Science Foundation of China, No. 81501817 and No. 81671836; Natural Science Youth Foundation of Jiangsu Province, No. BK20151029; and the Key Laboratory for Laboratory Medicine of Jiangsu Province of China, No. ZDXKB2016005.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jie-Xin Zhang, MD, PhD, Associate Professor, Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. jiexinzhang@njmu.edu.cn
Telephone: +86-25-68103450
Received: August 10, 2018
Peer-review started: August 10, 2018
First decision: October 9, 2018
Revised: November 2, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: January 6, 2019
Processing time: 147 Days and 7.7 Hours
Abstract
BACKGROUND

Cardiac toxic effect of tegafur (S-1) is extremely rare, and there has been no report on this issue so far.

CASE SUMMARY

We herein report a typical case of single S-1 administration after radical operation for colon cancer. The patient had no background or medical history of acute coronary syndrome (ACS), and only aortic and coronary atherosclerosis was revealed by computed tomography (CT) before surgery. He complained of sternum pain during the fifth cycle of S-1 treatment. Electrocardiogram (ECG) and serum cardiac marker cardiac troponin T (cTnT) strongly suggested ACS, which was possibly caused by S-1 cardiotoxicity.

CONCLUSION

Monitoring protocols based on ECG, CT, and cTnT should be performed in real time to evaluate cardiac function during S-1 administration.

Keywords: S-1; Acute coronary syndrome; Computed tomography; Electrocardiogram; Cardiac troponin T; Case report

Core tip: Cardiac toxic effect of tegafur (S-1) is extremely rare, and there has been no report on this issue so far. We herein report a typical case and review the literature. The case might contribute to improving our understanding of the pharmacology and mechanism of S-1 in treating colon cancer. This report also emphasizes the group of cancer patients who have already been diagnosed with cardiovascular atherosclerosis and serves as a reminder to gastroenterologists that delicate monitoring protocols should be carried out in real time to evaluate the cardiac function of S-1-onging patients.