Efficacy of glyceryl trinitrate in reducing cardiac events when given concomitantly with capecitabine for at least 3 months in various tumors

Capecitabine is an oral pro-drug of 5-flourouracil used in treatment of different cancers. It has cardiotoxicity incidence of 3-35%, which can be significant enough to cause myocardial infarction. To evaluate the efficacy of glyceryl trinitrate in reducing cardiac events when given concomitantly with capecitabine for at least 3 months in various tumors. A quasi-experimental study was conducted in Hameed Latif Hospital from January 2019 to December 2023. A total of 65 patients with various malignancies and ECOG 0-2 were included. Glyceryl trinitrate was given before capecitabine for at least 3 cycles with 2.6 mg dosage twice a day. Cardiotoxicity was assessed after each 21-days cycle by taking history and ECG. Echocardiogram was done at 3-month follow up Patients aged from 49 to 86 years. Adverse events were noted in 3 (4.6%) patients. Two patients (3.1%) suffered from angina (grade 2 cardiotoxicity) while 1 (1.5%) suffered from a myocardial infarction (grade 3 cardiotoxicity). On stratification, only treatment in adjuvant setting (p<0.001) was found to be a possible risk factor. Glyceryl trinitrate may have potential to be used concomitantly with capecitabine to reduce the frequency of serious cardiac events in cancer patients. However, further studies are needed.