Abnormal Cardiovascular Findings in Acute Pancreatitis: Are They Associated with Disease Severity?

Chacón-Portillo, Martin A.; Payro-Ramírez, Gerardo; Peláez-Luna, Mario; Uscanga-Domı́nguez, Luis; Vásquez-Ortiz, Zuilma Y.; Orihuela, Consuelo; Martínez-Vázquez, Sophia E.; Hernández-Calleros, Jorge

doi:10.24875/ric.17002361

Cited by 2 publications

(5 citation statements)

References 16 publications

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“…This is in line with existing literature [ 10 ]. Previous studies have observed a correlation between cardiac events and the severity of AP [ 6 ]. Various markers of cardiac injury have been linked to severe outcomes in patients with AP [ 9 , 15 , 21 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Given the significant morbidity and mortality that AP carries, it is necessary to understand the factors that significantly determine its prognosis. Various studies have identified abnormal cardiovascular findings in patients of AP [ 5 , 6 ]. ECG changes, including tachyarrhythmias, bradyarrhythmias, atrial flutter, atrial fibrillation, supraventricular premature contractions, short PR interval, QRS prolongation, bundle-branch blocks, T-wave flattening, and ST-segment depressions, have been observed in 25-50% patients of AP [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Researchers have found an association between high-sensitivity troponin-T (hs-TnT) levels and the severity of AP [ 7 ]. Contrarily, a study tested the relationship between cardiac troponin-I (cTnI) and AP prognosis and reported no association [ 6 ]. Yet another group of researchers found that creatine kinase myocardial band (CK-MB) levels predicted severe AP, whereas cTnI or N-terminal pro-brain natriuretic peptide (NT-proBNP) did not [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Type 2 Myocardial Infarction in Acute Pancreatitis: Analysis of 1.1 Million Hospitalizations and Review of the Literature

Khanna,

Patel,

Singh

et al. 2023

Cureus

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Introduction Acute pancreatitis (AP) is a common inflammatory disorder with acute onset and rapid progression. Studies have reported cardiac injury in patients with AP. It is often thought that stress cardiomyopathy can induce these changes leading to type 2 myocardial infarction (type 2 MI) in AP. Our study aims to assess the prevalence as well as the impact of type 2 MI on outcomes in patients with AP. Methods National Inpatient Sample (NIS) 2016-2020 was used to identify adult patients (age>18) with acute pancreatitis. We excluded patients with STEMI, NSTEMI, pancreatic cancer, or chronic pancreatitis. Patients with missing demographics and mortality were also excluded. Patients were stratified into two groups, based on the presence of type 2 MI. Multivariate logistic regression analysis was performed to assess the impact of concomitant type 2 MI on mortality, sepsis, acute kidney injury (AKI), ICU admission, deep venous thrombosis (DVT), and pulmonary embolism (PE) after adjusting for patient demographics, hospital characteristics, etiology of AP and the Elixhauser comorbidities. Results Of the 1.1 million patients in the study population, only 2315 patients had type 2 MI. The majority of the patients in the type 2 MI group were aged >65 years (49.2%, p<0.001), males (54.6%, p=0.63), White (67.6%, p=0.19), had Medicare insurance (55.5%, p<0.001), and were in the lowest income quartile (34.8%, p=0.12). Patients in the type 2 MI group had a higher incidence of mortality (5.4% vs 0.6%, p<0.001), sepsis (7.1% vs 3.7%, p<0.001), shock (9.3% vs 0.9%, p<0.001), AKI (42.9% vs. 11.8%, p<0.001) and ICU admission (12.1% vs 1.4%, p<0.001). After adjusting for confounding factors, patients in the type 2 MI group were noted to be at higher odds of mortality (aOR=2.4; 95% CI 1.5-3.8, p<0.001). Patients in the type 2 MI group had a longer length of stay (adjusted coefficient=2.1 days; 95% CI 1.4-2.8; p<0.001) and higher total hospitalization charges (adjusted coefficient=$45,088; 95% CI $30,224-$59,952; p<0.001). Conclusion Although the prevalence of type 2 MI in AP is low, the presence of type 2 MI is associated with increased mortality and worse outcomes. Physicians should be aware of this association and these patients should be monitored carefully to prevent worse outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Impact of Type 2 Myocardial Infarction in Acute Pancreatitis: Analysis of 1.1 Million Hospitalizations and Review of the Literature

Khanna,

Patel,

Singh

et al. 2023

Cureus

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“…A cross-sectional study in Mexico included 28 patients, with 55% having mild acute pancreatitis and 45% having moderate/severe acute pancreatitis [13]. The authors found that 67% had increased pro-brain natriuretic peptide levels, 52% had abnormal electrocardiogram (ECG) findings (with at least one of the following ECG findings: sinus tachycardia, bradycardia, QRS prolongation, QTc prolongation, right bundle branch block, left anterior fascicular branch block, non-specific repolarization changes, T-wave inversion, ST depression, ST elevation, left atrium abnormality, atrial fibrillation, inferior QS complex), 48% had abnormal echocardiographic findings (with at least one of the following findings on echocardiogram: right ventricle dilation, diastolic dysfunction, pulmonary hypertension, tricuspid regurgitation, mitral regurgitation, aortic insufficiency, left atrial dilation, hypokinesis, pulmonary insufficiency, systemic ejection fraction), and 18% had increased troponin levels.…”

Section: Acute Pancreatitis-associated Cardiac Injurymentioning

confidence: 99%

“…For example, CVD has been linked to an increased risk of acute pancreatitis [12]. Acute pancreatitis, in turn, has been associated with cardiac injury, and increased risk of ASCVD [13,14]. Similarly, the relationship between chronic pancreatitis and myocardial infarction has also been investigated in different studies [15,16].…”

Section: Introductionmentioning

confidence: 99%

Association of Cardiovascular Disease and Pancreatitis: What Came First, the Chicken or the Egg?

Chen,

Moin,

Virk

et al. 2023

JCM

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(1) Background: Recent studies suggest an association between pancreatitis and cardiovascular disease. This article aims to review the available evidence linking cardiovascular disease with acute and chronic pancreatitis. (2) Methods: A comprehensive search was conducted on the PubMed/MEDLINE database from inception to April 2022 using Medical Subject Heading and keywords related to pancreatitis and cardiovascular disease. The search was limited to English-language literature involving human subjects, and various study types, including observational studies, case–control studies, cohort studies, and clinical trials, were screened for eligibility. Following data extraction, the authors conducted a narrative synthesis of the studies. (3) Results: Longitudinal studies indicate that a history of acute pancreatitis is associated with an increased risk of acute atherosclerotic cardiovascular disease and acute coronary syndrome. Elevated triglyceride levels (>2000 mg/dL) have a temporal relationship with acute pancreatitis. Cross-sectional studies have shown that acute pancreatitis is associated with cardiac injury during the acute phase. Based on longitudinal studies, chronic pancreatitis is associated with an increased risk of cerebrovascular diseases. However, data regarding the relationship between chronic pancreatitis and myocardial infarction are conflicting. (4) Conclusions: Based on the available evidence, having a history of acute pancreatitis appears to increase the risk of acute atherosclerotic cardiovascular disease. However, there is insufficient evidence to conclude whether chronic pancreatitis is associated with cardiovascular disease, and no definitive studies have yielded conflicting results.

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Abnormal Cardiovascular Findings in Acute Pancreatitis: Are They Associated with Disease Severity?

Cited by 2 publications

References 16 publications

The Impact of Type 2 Myocardial Infarction in Acute Pancreatitis: Analysis of 1.1 Million Hospitalizations and Review of the Literature

The Impact of Type 2 Myocardial Infarction in Acute Pancreatitis: Analysis of 1.1 Million Hospitalizations and Review of the Literature

Association of Cardiovascular Disease and Pancreatitis: What Came First, the Chicken or the Egg?

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