Acute Coronary Syndrome Manifesting as an Adverse Effect of All-trans-Retinoic Acid in Acute Promyelocytic Leukemia: A Case Report with Review of the Literature and a Spotlight on Management

Table 3

Case reports of acute myocardial ischemia associated with ATRA.

Authors	Age (years)	Gender	Comorbidities	Presence of APL-DS	Type of myocardial ischemia	Treatment	Outcome
Tallman et al. [8]	52	Male	None	Yes	Acute myocardial infarction	ATRA was discontinued.	Patient died.
Miyoshi et al. [5]	71	Male	None	Yes	Acute myocardial infarction; (he also had lacunar infarction of right lentiform nucleus)	ATRA was discontinued.; Methyl prednisolone and; gabexate mesilate were administered.	Patient recovered.
De Santis et al. [6]	76	Female	None	Yes	Myocardial stunning; nonobstructive coronary artery disease	ATRA was discontinued. She was prescribed nitrates and dexamethasone.	Patient recovered.; ATRA was restarted. She tolerated treatment well. Echocardiogram done after two months showed normal left ventricular ejection fraction and no segmental hypocontractility.
Maqsood et al. [7]	65	Male	Hypertension, ulcerative colitis	Yes	Coronary vasospasm mimicking ST-elevation myocardial infarction	ATRA was discontinued.; Nitroglycerine, beta-blockers, and dexamethasone were given.; Dopamine infusion was started as the patient was hypotensive.	Patient recovered.
Our patient	42	Female	None	No	Acute coronary syndrome with left ventricular failure	ATRA was discontinued. She was prescribed metoprolol, ramipril, nitrates, and diuretics.	Patient recovered.