BACKGROUND AND AIM: The rate of cardiac injury in upper gastrointestinal hemorrhage is unclear. The aims of this study were to determine prospectively the risk of cardiac troponin I release and associated adverse cardiac events in patients with acute upper gastrointestinal hemorrhage. METHODS: From January to September 2003, we prospectively studied patients with documented hematemesis and melena referred to the gastroenterology unit in a tertiary teaching hospital in Melbourne, Australia. Serial assays for cardiac troponin I were performed at 0, 12 and 24 h. Serial creatine kinase levels and electrocardiographs were also performed. Clinical and biochemical data were collected. The primary endpoint was a troponin level >0.5 microg/L within 24 h of recruitment. Various clinical variables were then compared between the groups of patients with or without troponin rise. RESULTS: A total of 156 patients were included in the study. The mean age was 67 years (range 19-96). There were 104 (67%) male patients. A troponin level of greater than 0.5 microg/L was found in 30/156 (19%); 126 (81%) patients had normal troponin levels. Age greater than 65 years, signs of hemodynamic instability at presentation, a recent history of cardiac disease, cardiovascular compromise following endoscopy, and re-bleeding were associated with troponin release. CONCLUSION: Upper gastrointestinal bleeding is associated with a risk of cardiac injury of up to 19%. Troponin assay could be used to screen for cardiac damage, especially in elderly patients who present with hemodynamic instability.
BACKGROUND AND AIM: The rate of cardiac injury in upper gastrointestinal hemorrhage is unclear. The aims of this study were to determine prospectively the risk of cardiac troponin I release and associated adverse cardiac events in patients with acute upper gastrointestinal hemorrhage. METHODS: From January to September 2003, we prospectively studied patients with documented hematemesis and melena referred to the gastroenterology unit in a tertiary teaching hospital in Melbourne, Australia. Serial assays for cardiac troponin I were performed at 0, 12 and 24 h. Serial creatine kinase levels and electrocardiographs were also performed. Clinical and biochemical data were collected. The primary endpoint was a troponin level >0.5 microg/L within 24 h of recruitment. Various clinical variables were then compared between the groups of patients with or without troponin rise. RESULTS: A total of 156 patients were included in the study. The mean age was 67 years (range 19-96). There were 104 (67%) male patients. A troponin level of greater than 0.5 microg/L was found in 30/156 (19%); 126 (81%) patients had normal troponin levels. Age greater than 65 years, signs of hemodynamic instability at presentation, a recent history of cardiac disease, cardiovascular compromise following endoscopy, and re-bleeding were associated with troponin release. CONCLUSION:Upper gastrointestinal bleeding is associated with a risk of cardiac injury of up to 19%. Troponin assay could be used to screen for cardiac damage, especially in elderly patients who present with hemodynamic instability.
Authors: Nathaniel R Smilowitz; Matthew C Weiss; Rina Mauricio; Asha M Mahajan; Kaitlyn E Dugan; Arvind Devanabanda; Claudia Pulgarin; Eugenia Gianos; Binita Shah; Steven P Sedlis; Martha Radford; Harmony R Reynolds Journal: Int J Cardiol Date: 2016-05-13 Impact factor: 4.164
Authors: Meg Fraser; Arianne Clare C Agdamag; Valmiki R Maharaj; Melinda Mutschler; Victoria Charpentier; Mohammed Chowdhury; Tamas Alexy Journal: Biology (Basel) Date: 2022-03-28
Authors: Lena Mathews; Junichi Ishigami; Ning Ding; Ron C Hoogeveen; Anna Kucharska-Newton; Christie M Ballantyne; Rebecca Gottesman; Elizabeth Selvin; Kunihiro Matsushita Journal: J Am Heart Assoc Date: 2020-03-02 Impact factor: 5.501