Details

Autor(en) / Beteiligte

• Iser, David M
• Thompson, Alexander J V
• Sia, Koon Ket
• Yeomans, Neville D
• Chen, Robert Y M

Titel

Prospective study of cardiac troponin I release in patients with upper gastrointestinal bleeding

Ist Teil von

• Journal of gastroenterology and hepatology, 2008-06, Vol.23 (6), p.938-942

Ort / Verlag

Melbourne, Australia: Blackwell Publishing Asia

Erscheinungsjahr

2008

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• 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 μg/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 μg/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.