[Emergency coronary angioplasty following treatment with 5-fluorouracil]. / Angioplastie coronaire en urgence au décours d'une cure de 5-fluoro-uracile.

INTRODUCTION: The incidence of cardiac toxicity due to 5-fluorouracil (5-FU) ranges from 1.2 to 18%. Most complications occur at the time of the first cure. Their mechanisms have not yet been clearly defined. EXEGESIS: The authors report a case of unstable angina induced by 5-FU. A coronary angioplasty was performed on a previously ignored coronary lesion. CONCLUSION: Recent studies support the hypothesis that 5-FU has endothelial toxicity resulting in thrombogenic effect and release of vasoactive substances. Unstable angina pectoris would be related to plaque rupture caused by 5-FU. Patients with previous history of coronary disease are at significantly increased risk for 5-FU-induced cardiotoxicity. They probably would benefit from continuous electrocardiographic monitoring. Rechallenge with 5-FU after cardiotoxicity problems should include only those patients for whom there is no alternative treatment.