PhD Scientific Days 2025

Conservative Medicine II.

Cardiac Complications Associated with Acute Pancreatitis: A Systematic Review and Meta-analysis of Bidirectional Organ Interactions

Name of the presenter

Lillik Veronika

Institute/workplace of the presenter

Centre for Translational Medicine, Semmelweis University

Authors

Veronika Lillik¹, Mahmoud Obeidat¹, Dániel Sándor Veres², Péter Ferdinandy³, Elizabet Bodó¹, Asal Pourrastegar¹, Ali Moradi¹, Péter Hegyi⁴, Rita Nagy⁵

1: Centre for Translational Medicine, Semmelweis University
2: Department of Biophysics and Radiation Biology, Semmelweis University
3: Department of Pharmacology and Pharmacotherapy, Semmelweis University
4: Institute of Pancreatic Diseases, Semmelweis University
5: Heim Pál National Pediatric Institute, Budapest

Text of the abstract

Introduction: Acute pancreatitis (AP) is a systemic inflammatory disease with rising incidence and significant mortality, especially in severe cases. Cardiac abnormalities, including heart failure and arrhythmias, frequently occur during and after AP-related hospitalizations. However, the bidirectional relationship between cardiac changes and AP outcomes remains unclear.
Aims: This systematic review and meta-analysis aimed to investigate associations between cardiac abnormalities and AP outcomes, focusing on mortality, severity, and post-discharge complications.
Methosd: A systematic search of MEDLINE, Embase, and CENTRAL databases was conducted in November 2023. Observational studies and randomized controlled trials assessing cardiac abnormalities—such as atrial fibrillation (AF), repolarization changes, and QTc prolongation—in AP patients were included. Data on mortality and severity were analyzed using odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) in random-effects models.
Results: Thirty-two studies involving 5.3 million AP patients evaluated for cardiac abnormalities, were analyzed. AF significantly increased the odds of in-hospital mortality (OR: 2.69; CI: 1.34–5.38) during AP. Severe/moderately severe AP [(M)SAP] tripled the odds of ECG repolarization abnormalities compared to mild AP (OR: 2.75; CI: 1.19–6.36), while no significant association was found between (M)SAP and QTc prolongation. Chronic heart failure (CHF) significantly increased odds of mortality in AP (OR: 3.43; CI: 1.96–5.98).
Conclusion: This study highlights the significant reciprocal relationship between cardiac abnormalities and AP outcomes. Routine cardiac screening during hospitalization for AP, particularly in patients with pre-existing cardiac conditions, is recommended. Future research should explore long-term cardiovascular complications post-AP to improve patient outcomes.
Funding: Semmelweis University Research and Innovation Fund, Centre for Translational Medicine, and EKÖP-2024-11/EKÖP-2024-224 scholarships from Hungary's National Research, Development, and Innovation Fund. Sponsors had no role in the study design, data analysis, or manuscript preparation.