{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:04:00Z","timestamp":1780095840891,"version":"3.54.0"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pazopanib is a tyrosine kinase inhibitor approved for the treatment of metastatic renal cell carcinoma and advanced soft-tissue sarcoma that functions by inhibiting vascular endothelial growth factor receptors. Although the package insert and current cardio-oncology guidelines indicate a risk of acute coronary syndrome (ACS) associated with pazopanib, the causative role of pazopanib in arterial thrombosis is unclear due to a lack of focused coronary disease evaluation in oncological clinical trials prior to pazopanib initiation. Herein we present an antecedent ischemic evaluation of a patient who was prescribed pazopanib to demonstrate the first reported case of ACS directly attributable to pazopanib.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case description<\/jats:title><jats:p>A 65-year-old woman with metastatic leiomyosarcoma presented to the hospital with ACS. Pazopanib had been initiated 8 months prior, and an ischemic evaluation 6\u2005weeks prior to hospitalization indicated mild coronary artery disease (CAD). Emergent cardiac catheterization revealed a large thrombotic occlusion of the mid-left anterior descending coronary artery involving the secondary diagonal artery, which was treated with manual aspiration thrombectomy. Pazopanib was discontinued, and the patient was discharged from the hospital 12\u2005days later.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Although pazopanib is associated with ACS, there is a lack of definitive data supporting this association. This case-based demonstration of pazopanib-induced ACS provides a discrete clinical example of this phenomenon. The patient's minimal atherosclerotic burden 6\u2005weeks prior to her presentation for ACS strongly suggests causality attributable to pazopanib. Given the increased risk for ischemic heart disease, careful attention and an individualized risk assessment for CAD should be provided to patients who are prescribed pazopanib.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1466395","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T04:44:16Z","timestamp":1727153056000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Pazopanib-induced acute coronary syndrome"],"prefix":"10.3389","volume":"11","author":[{"given":"Adithya K.","family":"Yadalam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Schultz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanhee","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anant","family":"Mandawat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"B1","article-title":"U.S. Food and Drug Administration website","year":"2009"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4229","DOI":"10.1093\/eurheartj\/ehac244","article-title":"2022 ESC guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS): developed by the task force on cardio-oncology of the European Society of Cardiology (ESC)","volume":"43","author":"Lyon","year":"2022","journal-title":"Eur Heart J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"E202","DOI":"10.1002\/ccd.26379","article-title":"SCAI expert consensus statement: evaluation, management, and special considerations of cardio-oncology patients in the cardiac catheterization laboratory (endorsed by the Cardiological Society of India, and Sociedad Latino Americana de Cardiolog\u0131a Intervencionista)","volume":"87","author":"Iliescu","year":"2016","journal-title":"Catheter Cardiovasc Interv"},{"key":"B4","doi-asserted-by":"publisher","first-page":"5481","DOI":"10.1158\/1078-0432.CCR-10-3409","article-title":"A phase II study of pazopanib in Asian patients with recurrent\/metastatic nasopharyngeal carcinoma","volume":"17","author":"Lim","year":"2011","journal-title":"Clin Cancer Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1879","DOI":"10.1016\/S0140-6736(12)60651-5","article-title":"Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial","volume":"379","author":"van der Graaf","year":"2012","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1093\/jjco\/hyv184","article-title":"A randomized, double-blind, placebo-controlled, phase III study of pazopanib in patients with soft tissue sarcoma: results from the Japanese subgroup","volume":"46","author":"Kawai","year":"2016","journal-title":"Jpn J Clin Oncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1177\/1074248418769612","article-title":"The impact of pazopanib on the cardiovascular system","volume":"23","author":"Justice","year":"2018","journal-title":"J Cardiovasc Pharmacol Ther"},{"key":"B8","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/978-3-031-08309-9_4","article-title":"Intracellular cardiac signaling pathways altered by cancer therapies","author":"Scott","year":"2022","journal-title":"Cardiovasc Signal Health Dis"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1200\/JCO.2009.23.9764","article-title":"Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial","volume":"28","author":"Sternberg","year":"2010","journal-title":"J Clin Oncol"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2024.1466395\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T04:44:17Z","timestamp":1727153057000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2024.1466395\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,24]]},"references-count":9,"alternative-id":["10.3389\/fcvm.2024.1466395"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2024.1466395","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,24]]},"article-number":"1466395"}}