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• W2018116541 abstract "<h3>Background</h3> Biochemical markers of ERCP-related myocardial injury have not previously been investigated. <h3>Objective</h3> To evaluate ERCP-related cardiac troponin I (cTnI) release, myocardial ischemia, hemodynamic changes, and arterial hypoxemia in a series of consecutive patients according to age and to determine their relationship to preexisting cardiovascular risk factors (RF) and the development of post-ERCP pancreatitis. <h3>Design</h3> Prospective cohort study. <h3>Setting</h3> Tertiary teaching hospital, Canberra, Australia. <h3>Patients</h3> Data were collected on 130 consecutive ERCPs performed on 100 unselected patients (aged 18-93 years) by one endoscopist. Patients were divided into two groups: 65 years of age and older (group 1, n=53; 27 women) and less than 65 years of age (group 2, n=47; 33 women). <h3>Interventions</h3> ERCP. <h3>Main Outcome Measurements</h3> Cardiovascular RFs were identified, and electrocardiogram (ECG), cTnI, creatine kinase (CK), amylase, and lipase were measured before and 24 hours after ERCP. Oxygen saturation (SpO₂), heart rate (HR), blood pressure (BP), and ECG were monitored continuously during each procedure. <h3>Results</h3> New ECG changes (ischemia, arrhythmias) occurred in 24% of procedures in group 1 and in 9.3% in group 2 (<i>p</i> = 0.168), and episodic arterial hypoxemia (SpO₂ < 90%) in 16.2% (group 1) and 21.4% (group 2) (<i>p</i> = 0.596). A post-ERCP rise in cTnI levels was documented in 6 patients in the older group. Two of these patients died: one from acute myocardial infarction and one from undiagnosed ascending aortic aneurysm. A cTnI rise was not related to any comorbid conditions, total number of RFs, hemodynamic or ECG changes, or arterial desaturation. In patients with a new cTnI rise, the duration of ERCP was significantly longer (59.5 vs. 26.4 minutes, <i>p</i> = 0.026), being 30 minutes or longer in 5 of 6 patients. Post-ERCP pancreatitis was associated with desaturation (relative risk [RR] = 5.9; 95% confidence interval [CI] [1.2, 32.0], <i>p</i> = 0.027) and myocardial ischemia/injury (RR = 4.4; 95% CI [1.4, 7.8]; <i>p</i> = 0.009). <h3>Conclusions</h3> Although the majority of older patients tolerated ERCP well, in 8% of procedures, most of which were prolonged (>30 minutes), myocardial injury, as defined by the release of cTnI, occurred. Desaturation and myocardial ischemia/injury were associated with post-ERCP pancreatitis." @default.
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• W2018116541 title "Cardiopulmonary complications of ERCP in older patients" @default.
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• W2018116541 doi "https://doi.org/10.1016/j.gie.2005.09.020" @default.
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