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

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 5^th 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.