与氨酸激酶抑制剂sunitinib相关的心脏毒性
Tammy F Chu1, Maria A Rupnick, Risto Kerkela
1Department of Cardiology, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
Lancet (London, England)
|December 18, 2007
概括
苏尼提尼布治疗胃肠道 stromal 瘤可能会导致心血管事件,包括心力衰竭和左心室喷射率 (LVEF) 降低. 建议在接受sunitinib的患者中密切监测高血压和LVEF变化.
科学领域:
- 心血管研究的心血管研究.
- 在瘤学瘤学.
- 药理学 药理学 是一个学科.
背景情况:
- 苏尼提尼布是一种经批准的氨酸激酶抑制剂,可延长转移性癌症的存活时间.
- 有关sunitinib的心脏安全性概况存在担忧.
- 这项研究评估了转移性胃肠道 stromal 瘤 (GIST) 患者接受sunitinib治疗的心血管风险.
研究的目的:
- 评估转移性GIST患者中与sunitinib相关的心血管风险.
- 调查sunitinib对左心室喷射率 (LVEF) 和血压的影响.
- 探索苏尼蒂尼布诱导心脏影响的潜在机制.
主要方法:
- 在75名患有抗伊马替尼布转移性GIST的患者中,对心血管事件的回顾性审查.
- 综合心血管终点的分析:心脏死亡,心肌梗塞,充血性心力衰竭.
- 使用大鼠心肌细胞和小鼠进行体外和体内研究,以研究心脏毒性机制.
主要成果:
- 11%的患者患有心血管事件,8%患有充血性心力衰竭.
- 在接受批准剂量的患者中,28%的患者显示LVEF减少至少10%.
- 47%的患者患有高血压;苏尼替尼诱导心肌细胞亡和线粒体损伤.
结论:
- 左心室功能障碍可能是直接心肌细胞毒性和高血压的结果.
- 接受sunitinib治疗的患者需要密切监测高血压和LVEF降低.
- 以前患有心脏病的个人应该特别小心.
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