Comprehensive review of cardiovascular toxicity of drugs and related agents

Med Res Rev. 2018 Jul;38(4):1332-1403. doi: 10.1002/med.21476. Epub 2018 Jan 5.

Abstract

Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases. Due to the large number of clinically relevant compounds discussed, this article could be of interest to a broad audience including pharmacologists and toxicologists, pharmacists, physicians, and medicinal chemists. Particular emphasis is given to clinically relevant topics including the cardiovascular toxicity of illicit sympathomimetic drugs (e.g., cocaine, amphetamines, cathinones), drugs that prolong the QT interval, antidysrhythmic drugs, digoxin and other cardioactive steroids, beta-blockers, calcium channel blockers, female hormones, nonsteroidal anti-inflammatory, and anticancer compounds encompassing anthracyclines and novel targeted therapy interfering with the HER2 or the vascular endothelial growth factor pathway.

Keywords: dysrhythmia; heart failure; hypertension; myocardial infarction; stroke.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects*
  • Alkaloids / adverse effects
  • Amphetamines / adverse effects
  • Animals
  • Anti-Arrhythmia Agents / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Antineoplastic Agents / adverse effects
  • Calcium Channel Blockers / adverse effects
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular System / drug effects*
  • Cocaine / adverse effects
  • Digoxin / adverse effects
  • Female
  • Heart Rate / drug effects
  • Hormones / adverse effects
  • Humans
  • Male
  • Steroids / adverse effects*
  • Stroke / drug therapy
  • Vascular Endothelial Growth Factor A

Substances

  • Adrenergic beta-Antagonists
  • Alkaloids
  • Amphetamines
  • Anti-Arrhythmia Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antineoplastic Agents
  • Calcium Channel Blockers
  • Hormones
  • Steroids
  • Vascular Endothelial Growth Factor A
  • cathinone
  • Digoxin
  • Cocaine