A patient with triple-negative breast cancer developed acute myocardial infarction after docetaxel chemotherapy: case report and literature review

We report the first case of an acute ST-segment elevation myocardial infarction (AMI) induced by docetaxel in a patient with triple-negative breast cancer (BC). Coronary angiography showed severe occlusions in multiple coronary arteries, and timely PCI surgery was successfully performed, saving the patient's life. Docetaxel is a commonly used taxane chemotherapy drug for treating breast cancer, which can cause numerous adverse drug reactions in cancer treatment. However, compared with paclitaxel, reports of docetaxel-induced cardiotoxicity are fewer and generally milder, and acute myocardial infarction induced by docetaxel is extremely rare and potentially fatal when it occurs. Due to this severe adverse drug reaction, the subsequent docetaxel chemotherapy regimen was discontinued. In addition, we review this case alongside 12 published case reports and conduct a comprehensive analysis of 94 reported instances of myocardial infarction associated with taxane use from the FDA Adverse Event Reporting System (FAERS) database, evaluating their clinical relevance and key characteristics. In this case, we highly suspect that docetaxel directly caused the acute myocardial infarction, and propose that the mechanism may involve coronary vasospasm, endothelial dysfunction, or prothrombotic effects, although the exact pathway remains unclear. This study, through the rare case of a breast cancer patient who experienced acute myocardial infarction after docetaxel chemotherapy, demonstrates timely and proper cardiac management in a patient assessed as low-risk for cardiotoxicity with no relevant cardiovascular factors. Furthermore, through literature review combined with the FAERS database, we further discuss possible mechanisms, influencing factors, and predictive methods to provide clinical reference and warnings.