Why the study?
Regorafenib is known to cause cardiac side effects such as hypertension, but myocardial ischemia is a very extraordinary adverse effect.
Regorafenib, a multi-kinase inhibitor, may cause ST-elevation myocardial infarction as a rare adverse effect even in the absence of atherosclerotic coronary lesions.
Myocardial ischemia may occur on regorafenib; this case leaves open its incidence and causality in larger cohorts.
Regorafenib is an oral multi-kinase inhibitor that is used in the treatment of chemotherapy-resistant metastatic colorectal carcinoma. However, multi-kinase inhibitors have been known to cause cardiac side effects, most notably hypertension. Myocardial ischemia is a very extraordinary adverse effect of regorafenib. Our patient was a 74-year-old gentleman with stage IVa colon cancer who underwent a right colectomy with end ileostomy and was on cycle two of regorafenib during the presentation. He came in with acute onset chest pain that was intermittent, non-exertional, and radiating to the back. His left heart catheterization did not reveal any atherosclerotic lesions, and his ST-elevation myocardial infarction (STEMI) was deemed an extremely rare adverse event from regorafenib. We are herewith reporting a case of regorafenib-induced STEMI.
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Karki et al. (2023) studied this question.
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