Cardiotoxic reactions induced by apatinib mesylate tablets
Department of Pharmacy, the Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, Suzhou 215153, China; Department of Oncology, the Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University, Suzhou 215153, China
Abstract：A 59-year-old female patient received targeted therapy with apatinib mesylate tablets (500 mg orally, once daily) for neuroendocrine tumor-derived intraperitoneal metastasis. On the 3rd day of treatment, the patient suddenly developed chest distress and shortness of breath, her blood pressure was 170/102 mmHg, and heart rate was 43 beats/min. The electrocardiogram showed sinus bradycardia and prolonged QT interval from 412 ms before treatment to 502 ms. Her N-terminal probrain natriuretic peptide (NT-proBNP) was 2 945 ng/L. Apatinib was withdrawn and symptomatic treatments such as oxygen inhalation, antihypertension, and myocardial nutrition were given. Two days later, her symptoms gradually relieved, blood pressure returned to normal, and NT-proBNP decreased to 291 ng/L. After the symptoms disappeared, the patient took apatinib (125 mg once daily) again. Seven days later, dizziness and hypertension occurred again and her NT-proBNP was 782 ng/L. After apatinib withdrawal and symptomatic treatments, the patient′s symptoms improved.
