Table 3 Proposed Mechanisms of Fluoropyrimidine Induced Cardiotoxicity
From: 5-FU induced cardiotoxicity: case series and review of the literature
Coronary Vasospasm | Direct Myocardial Injury | Vascular Endothelial Dysfunction | Impaired Oxygen Delivery |
|---|---|---|---|
● Protein kinase C ● Endothelin-I | ● Alpha-fluoro-beta-alanine (FBAL) (breakdown product of 5-FU) | ● Microthrombotic occlusions resulting from direct toxic effect of 5-FU on vascular endothelial cells ● Oxygen free radicals | ● Erythrocyte membranes change leading to diminished ability to deliver oxygen |