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• W1999762525 abstract "Introduction: Methodological/procedural risks of ERCP are well known, but cardiac risks have not been studied, specifically. Troponin I (TnI) is a cardio-selective enzyme that can aid in detection of even small amounts of myocardial damage. This prospective study examined the TnI levels of patients before and after ERCP to assess for cardiac injury, e.g. caused by administration of antimotility agents that can produce tachycardias (Scopolamine, Glucagon). Methods: 100 patients (57 f, 43 m, age 20-93, mean 62 y) were randomized prospectively to administration of Scopolamine or Glucagon as the antimotility agent during ERCP (30% diagnostic, 70% therapeutic). 65% of patients had one or more cardiovascular risk factors. TnI [normal value 0-0.4 ng/ml] was measured at baseline, at 8 h, and, if elevated, at 20 h post ERCP. Patients were sedated with Midazolam, Midazolam/Pentazocin or Propofol, given nasal O₂(2 l/min), and were monitored during ERCP for heart rate, blood pressure, pulse oximetry. Results: Mean duration of ERCP was 28 min. 8 patients (5 with Scopolamine, 3 with Glucagon) had elevated TnI levels: 6 already had elevated levels at baseline (0.5-2.5ng/ml; mean 1.13), with subsequent decrease to normal in 4 patients over the 8/20 h after ERCP. The remaining 4 (2 with TnI elevations at baseline, 2 with normal TnI at baseline) had a rise in TnI levels from 0-1.3 (mean 0.47) ng/ml at baseline to 0.9-18.4 (mean 5.48) ng/ml at 8 h, to 0.6-7.8 (mean 2.75) ng/ml at 20 h after ERCP. 3 of these 4 patients had ERCP's of more than 30 min in duration (range 32-115 min). In the patients with a rise in TnI no cardiac symptoms or complication occurred during or after the ERCP. There was no correlation of an increase in TnI with tachycardias (pulse >120), hypoxic episodes (O₂- Sat < 95%), or systolic BP elevations (>160 mm Hg). No difference was found between administration of Scopolamin versus Glucagon: Heartrates of >100/min and/or systolic BP >160 mm Hg occurred in 33 patients after Scopolamin and 34 patients after Glucagon without change in TnI. 22 patients had stable vital signs. Conclusions: In this study an increasing TnI level was observed in 4% of patients undergoing ERCP. This correlated only with duration of the procedure (>30 min). No difference was found with regard to choice of antimotility agent (Scopolamine versus Glucagon). No clinically relevant cardiac symptoms or cardiovascular problems resulted in any patient with TnI elevation. In this study ERCP appeared to be safe from a cardiovascular standpoint, even for multimorbid patients." @default.
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• W1999762525 date "2000-04-01" @default.
• W1999762525 modified "2023-10-18" @default.
• W1999762525 title "3355 Troponin i determination to detect subclinical cardiac ischemia during ercp." @default.
• W1999762525 doi "https://doi.org/10.1016/s0016-5107(00)14055-6" @default.
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