Acute pancreatitis and myocardial damage
GianVico Melzi d'Eril1,*, Raffaele Pezzilli2, Giovanni M Colpi3, Massimiliano M Corsi Romanelli4, Alessandra Barassi1
1Laboratorio di Analisi, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, 2Dipartimento di Malattie dell’Apparato Digerente e Medicina Interna, Ospedale Sant'Orsola-Malpighi, Alma Mater Studiorum, Università degli Studi di Bologna, Bologna, 3ISES – Istituto per la Sterilità e la Sessualità, Milan, 4Unità Operativa Medicina di Laboratorio -1 Patologia Clinica, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy
Introduction: Elevated serum concentrations of markers of myocardial damage has been anecdotically found in acute pancreatitis.
Objectives: To evaluate the serum levels of cTnT, CK, CK-MB and NT-pro-BNP in a consecutive series of patients with acute pancreatitis during the first 72 hours of the disease.
Methods: Thirty-seven acute pancreatitis patients were studied within 24 hours of the onset of pain without clinical or electrocardiographic signs of acute myocardial infarction. Serum cTnT, CK, CK-MB and NT-pro-BNP, amylase, lipase and C-reactive protein (CRP) were assayed.
Results: No significant modification of serum cTnT, CK, CK-MB and NT-pro-BNP concentrations were found during the 3 days of the study while amylase and lipase activity significantly decreased (P<0.001), and CRP significantly increased (P<0.001). No significant differences in serum cTnT, CK-MB and NT-pro-BNP concentrations were found between patients with mild and those with severe pancreatitis during the three days of the study while CK was significantly higher in severe pancreatitis than in those with mild disease on the first (P=0.003) and on the second day (P=0.027) of the study period.
Conclusion: The presence of elevated levels of cTnT, CK and NT-pro-BNP in patients with acute pancreatitis, without clinical or electrocardiographic signs of acute myocardial infarction, should be interpreted as possible rhabdomyolysis.
Keywords: Biomarker, Cardiovascular, Heart