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Caspofungin-Induced Cardiotoxicity in Patients Treating for Candidemia Publisher



Sattarzadeh Badkoubeh R1 ; Farajpour M1 ; Salehi M2 ; Sherafati A1 ; Zamani Z3 ; Rezahosseini O4 ; Mansouri P5 ; Sardari A1
Authors
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Authors Affiliations
  1. 1. Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, P.O. Box 14197-33141, Tehran, Iran
  2. 2. Department of Infectious diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, P.O. Box 14197-33141, Tehran, Iran
  3. 3. Department of Community Medicine, Tehran University of Medical Sciences, P.O. Box 14155-6559, Tehran, Iran
  4. 4. Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, 2100, Denmark
  5. 5. Tehran Heart Center, Tehran University of Medical Sciences, P.O. Box 14155-6559, Tehran, Iran

Source: Toxics Published:2022


Abstract

Echinocandins selectively inhibit fungal cell wall synthesis and, therefore, have few side effects. However, there are reports of hemodynamic and cardiac complications. We conducted this study to investigate the effects of caspofungin both on the noninvasive echocardiographic indices of myocardial function and myocardial injury based on serum high-sensitivity cardiac troponin I (hs-cTnI) levels. This study was conducted on patients treated for candidemia. The hs-cTnI level and echocardiographic parameters were measured before and 1 h after the infusion of the induction dose of caspofungin. Data were compared between central and peripheral venous drug administration routes. Fifteen patients were enrolled in the study. There were no significant differences in the echocardiographic parameters between the baseline and post-treatment period. The mean hs-cTnI level exhibited a significant rise following drug administration (0.24 ± 0.2 ng/mL vs 0.32 ± 0.3 ng/mL; p = 0.006). There was also a significant difference concerning the hs-cTnI level between central and peripheral venous drug administration routes (p = 0.034). Due to differences in the hs-cTnI level, it appears that the administration of caspofungin may be associated with myocardial injury. Our findings also showed a higher possibility of cardiotoxicity via the central venous administration route. © 2022 by the authors.