Sejla Sehovic
New Westminster College, Canada
Title: Highly sensitive troponin in myocardial ischemia during endoscopic retrograde cholangiopancreatography
Biography
Biography: Sejla Sehovic
Abstract
Background: Procedural riks of ERCP are well recognized but significance of cardiac risks remains controversial.This study aimed to evaluate ERCP-related highly sensitive cardiac troponin I (hs TnI) release in even small amounts of myocardial injury and to analyze potential relationship between myocardial ischemia and the development of post-ERCP pancreatitis.
Methods: 120 patients (aged 18-93 years) scheduled for ERCP were enrolled in this study. Cardiovascular risk factors were identified in 60% of patients.All patients were assessed clinically and with electrocardiography for the presence of ischemic disease before the procedure. Hs TNI ( limit of detection 1,9ng/l) was measured at baseline(pre- ERCP), during ERCP and 2h post-ERCP. During ERCP procedure patients were also monitored with Holter tape rekorder. Amylase and lipase were measured before and 24 hours after ERCP.
Results: Twelve patients (12 %)developed myocardial ischemia/injury during ERCP with new ECG changes and without any clinical symptom. 50 % of change in Hs TnI second measurement was documented in 12 patients ( p<0.01) .Patients with myocardial ischemia during ERCP had a significantly higher values of amylase and lipase levels(60,3%vs 16.2%; p<0.01)
Conclusions: The relationship was found between hs TnI small elevation and new ECG and rythm changes on Holter during ERCP. Post ERCP pancreatitis was associated with myocardial ischemia/injury during ERCP.