Myocardial infarction risk with capecitabine therapy
Capecitabine therapy is associated with a low absolute risk of myocardial infarction (MI). In a Danish nationwide registry study of patients with gastrointestinal cancer, the cumulative MI incidence was 0.6% at 6 months and 0.7% at 1 year. [1]
Absolute MI incidence estimates
- At 6 months, cumulative MI incidence was 0.6% (95% CI 0.5% to 0.7%) with capecitabine versus 0.3% (95% CI 0.3% to 0.4%) in controls. [1]
- At 1 year, cumulative MI incidence was 0.7% (95% CI 0.6% to 0.9%) with capecitabine versus 0.6% (95% CI 0.5% to 0.6%) in controls. [1]
Relative MI risk compared with controls
- After accounting for competing risks, MI risk was higher at 6 months with capecitabine versus controls (subdistribution hazard ratio 2.02; 95% CI 1.57 to 2.60). [1]
- After accounting for competing risks, MI risk remained higher at 12 months with capecitabine versus controls (subdistribution hazard ratio 1.28; 95% CI 1.05 to 1.57). [1]
Clinical interpretation of absolute risk
- The absolute MI risk increase was small despite statistically significant relative risk increases at 6 and 12 months. [1]
- Competing mortality was substantial in the study population, with competing risk of death at 6 months of 15.2% in the capecitabine group versus 0.7% in controls. [1]