# Systematic review and meta-analysis of cardiac complications in acute pancreatitis

## TL;DR

This study finds that heart conditions like atrial fibrillation and heart failure significantly increase the risk of death in patients with acute pancreatitis.

## Contribution

The paper systematically links specific cardiac abnormalities to acute pancreatitis outcomes using a large-scale meta-analysis.

## Key findings

- Atrial fibrillation triples the odds of death in acute pancreatitis patients.
- Severe acute pancreatitis is associated with ECG repolarization changes.
- Pre-existing heart failure increases mortality risk in acute pancreatitis.

## Abstract

Cardiovascular abnormalities are associated with acute pancreatitis (AP). Here, we temporarily link these abnormalities to AP outcomes. We systematically searched PubMed, EMBASE, and Cochrane on 5th November 2023 and included 44 studies (n = 5.3 million patients, 63.8% retrospective) containing United States National Inpatient Sample cohorts, where overlap may occur; without these databases, 1.2 million patients remained. We analyzed chronic heart failure (CHF), atrial fibrillation (AF), repolarization changes, and QTc prolongation on ECG in association with mortality and severity using odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) in a random-effects model. AP patients with AF face 2.69-fold increased odds of mortality in AP (OR, 2.69; CI, 1.34–5.38). Severe and moderately severe AP ([M]SAP) is associated with 2.75-times higher odds of repolarization changes on ECG (OR, 2.75; CI, 1.19–6.36). Cardiac assessment is essential in acute pancreatitis; prospective studies should address long-term cardiovascular complications.

•Pre-existing heart failure increases the odds of mortality in acute pancreatitis•Atrial fibrillation triples the odds of death among acute pancreatitis patients•Severe acute pancreatitis is linked to ECG repolarization abnormalities•Cardiologic screening should be included in acute pancreatitis management

Pre-existing heart failure increases the odds of mortality in acute pancreatitis

Atrial fibrillation triples the odds of death among acute pancreatitis patients

Severe acute pancreatitis is linked to ECG repolarization abnormalities

Cardiologic screening should be included in acute pancreatitis management

Cardiovascular medicine; Human metabolism; Public health