Original Article

Role of serum myeloperoxidase, CPK, CK-MB, and cTnI tests in early diagnosis of myocardial ischemia during ERCP

Volume 25 · Issue 3 Publish Date: June 15, 2014
Kemal Yıldız Ali Tüzün İnce Ahu Sarbay Kemik Selin Sert Hayati Can İsen Mukaddes Tozlu Birol Baysal Ümit Akyüz Orhan Kocaman Ahmet Danalıoğlu
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Turkish Journal of Gastroenterology

Volume 25 · Issue 3

Pages: 291-297

History

Published Online: June 15, 2014

Copyright © 2014 Kemal Yıldız, Ali Tüzün İnce, Ahu Sarbay Kemik, Selin Sert, Hayati Can İsen, Mukaddes Tozlu, Birol Baysal, Ümit Akyüz, Orhan Kocaman, Ahmet Danalıoğlu

Kemal Yıldız
Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey
Ali Tüzün İnce
Department of Gastroenterology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
Ahu Sarbay Kemik
Department of Biochemistry, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
Selin Sert
Department of Gastroenterology, Bezmialem Vakif University Medical School, İstanbul, Turkey
Hayati Can İsen
Department of Gastroenterology, Bezmialem Vakif University Medical School, İstanbul, Turkey
Mukaddes Tozlu
Department of Gastroenterology, Bezmialem Vakif University Medical School, İstanbul, Turkey
Birol Baysal
Department of Gastroenterology, Bezmialem Vakıf University, İstanbul, Turkey
Ümit Akyüz
Department of Gastroenterology, Yeditepe University Faculty of Medicine, İstanbul, Turkey
Orhan Kocaman
Department of Gastroenterology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
Ahmet Danalıoğlu
Department of Internal Medicine, Division of Gastroenterology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey
Yıldız, K., Tüzün İnce, A., Sarbay Kemik, A., Sert, S., İsen, H. C., Tozlu, M., … Danalıoğlu, A. (2014). Role of serum myeloperoxidase, CPK, CK-MB, and cTnI tests in early diagnosis of myocardial ischemia during ERCP. Turkish Journal of Gastroenterology, 25(3), 291–297. https://doi.org/10.5152/tjg.2014.4716
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Abstract

Abstract Background/Aims: Some patients may experience retrosternal pain during ERCP, which may be a pioneer of a serious myocardial problem, and early diagnosis is very important for the prognosis and management. In the study, we aimed to investigate the role of serum cardiac biomarkers, such as myeloperoxidase (MPO), creatine phospokinase (CPK), creatine kinase- myocardial band (CK-MB), and cTnI, on early diagnosis of myocardial ischemia during endoscopic retrograde cholangio pancreaticograpy (ERCP) procedures. Materials and Methods: In this prospective observational study, ERCP patients were separated into ischemic cardiac (n:48) and non-ischemic (n:76) groups. Serious cardiac, kidney, and liver disease patients were excluded from the study. Changes in electrocardigrapy (ECG), blood pressure, pulse rate, oxygen saturation, and serum MPO, CPK, CK-MB, and cTnI levels were investigated before and after the ERCP. Results were evaluated statistically (p<0.05). Results: Mean age was 59.76±16.62 (55♀, 69♂). Only one patient had clinically unimportant retrosternal pain (0.8%). ST-elevation was detected in 10.4% (n:5), ST-depression in 12.5% (n:6), and negative-T in 31.3% (n:15) of ischemic patients during ERCP. Systolic and diastolic blood pressure and pulse rates in both groups and oxygen saturations in the ischemic group were reduced after ERCP. Significance was not detected with MPO and CPK tests. CK-MB levels showed an increase after the ERCP in the non-ischemic group (p<0.001). cTnI means were higher among the ischemics when pre- and post-ERCP periods (p:0.001) were compared. Conclusion: Clinically unimportant retrosternal pain, T negativity, and ST segment changes as well as reduced systolic, diastolic blood pressure, and heart rates can be seen during ERCP. MPO and CPK levels remain insignificant if myocardial injury does not develop. Increased CK-MB levels in non-ischemic patients and increased cTnI levels in ischemics may be seen.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 25 · Issue 3
Pages 291-297
DOI 10.5152/tjg.2014.4716
History
Published Online June 15, 2014
Copyright
Copyright (c) 2014 Kemal Yıldız, Ali Tüzün İnce, Ahu Sarbay Kemik, Selin Sert, Hayati Can İsen, Mukaddes Tozlu, Birol Baysal, Ümit Akyüz, Orhan Kocaman, Ahmet Danalıoğlu
Affiliations
Kemal Yıldız
Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey
Ali Tüzün İnce
Department of Gastroenterology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
Ahu Sarbay Kemik
Department of Biochemistry, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
Selin Sert
Department of Gastroenterology, Bezmialem Vakif University Medical School, İstanbul, Turkey
Hayati Can İsen
Department of Gastroenterology, Bezmialem Vakif University Medical School, İstanbul, Turkey
Mukaddes Tozlu
Department of Gastroenterology, Bezmialem Vakif University Medical School, İstanbul, Turkey
Birol Baysal
Department of Gastroenterology, Bezmialem Vakıf University, İstanbul, Turkey
Ümit Akyüz
Department of Gastroenterology, Yeditepe University Faculty of Medicine, İstanbul, Turkey
Orhan Kocaman
Department of Gastroenterology, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey
Ahmet Danalıoğlu
Department of Internal Medicine, Division of Gastroenterology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey
Cite this Article
Yıldız, K., Tüzün İnce, A., Sarbay Kemik, A., Sert, S., İsen, H. C., Tozlu, M., … Danalıoğlu, A. (2014). Role of serum myeloperoxidase, CPK, CK-MB, and cTnI tests in early diagnosis of myocardial ischemia during ERCP. Turkish Journal of Gastroenterology, 25(3), 291–297. https://doi.org/10.5152/tjg.2014.4716
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