PhD Scientific Days 2025
Budapest, 7-9 July 2025
Health Sciences III.
Cardiac Complications in Acute Pancreatitis: A Systematic Review and Meta-analysis of Bidirectional Organ Interactions
Name of the presenter
Nagy Rita
Institute/workplace of the presenter
Centre for Tranlastional Medicine, Semmelweis University ; Heim Pál National Pediatric Institute
Authors
Rita Nagy1, Veronika Lillik2,3, Peter Ferdinandy2,4, Dániel Sándor Veres2,5, Mahmoud Obeidat2, Elizabet Bodó2, Ali Moradi2, Péter Hegyi2,6
1: Centre for Tranlastional Medicine, Semmelweis University ; Heim Pál National Pediatric Institute
2: Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
3: First Department of Internal Medicine, Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
4: Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary
5: Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
6: Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
Text of the abstract
Introduction:Acute pancreatitis (AP) is a systemic inflammatory disease with a rising incidence and high mortality, particularly in severe cases. Cardiac abnormalities, including heart failure and arrhythmias, are frequently observed during and after AP-related hospitalizations. Despite the known association between AP and cardiac complications, the bidirectional relationship between cardiac changes and AP outcomes remains poorly understood. This study aims to systematically review and meta-analyze the bidirectional associations between cardiac abnormalities and AP outcomes, focusing on mortality, severity, and post-discharge complications.
Methods: A systematic search was conducted on November 5, 2023, across MEDLINE, Embase, and Cochrane CENTRAL, with additional backward and forward citation searches completed on February 19, 2024. The study protocol was registered on PROSPERO (CRD42023479679, CRD42023479674). Data on mortality and AP severity were analyzed using odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI) in a random-effects model.
Results:Thirty-two studies involving 5.3 million patients were included, with 1.3 million AP patients analyzed for specific cardiac abnormalities. Patients with AF had nearly threefold higher odds of in-hospital mortality compared to those without AF (OR: 2.69; CI: 1.34–5.38). Severe and moderately severe AP [(M)SAP] tripled the odds of ECG repolarization changes compared to mild AP (OR: 2.75; CI: 1.19–6.36). Pre-existing chronic heart failure (CHF) was associated with a threefold increased odds of mortality (OR: 3.43; CI: 1.96–5.98). Elevated cardiac laboratory markers, including creatine kinase-MB (CK-MB), were associated with higher mortality and longer hospital stays.
Conclusion:This study highlights the significant bidirectional relationship between cardiac abnormalities and AP outcomes that underscore the importance of routine cardiology screening in AP patients during hospitalization. Future research should focus on longitudinal studies to better understand the long-term cardiovascular complications following AP.
Funding: Funding is provided by the EKÖP-2024-11, University Research Scholarship Program from the source of the National Research, Development, and Innovation Fund Hungary.