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Serum myeloperoxidase, CPK, CK-MB, and cTnI levels in early diagnosis of myocardial ischemia during ERCP; once or repeated once?

In the 2014 (25) issue of Turkish Journal of Gastroenterology, Yıldız et al. (1) reported that the increase in troponin levels during ERCP may show cardiac damage. Patients undergoing ERCP, who were diagnosed in advance of having ischemic cardiac problems (n=48) and without cardiac problems (n=76), were recruited in this study. Before and after ERCP, ECG, blood pressure, heart rate, oxygen saturation levels, MPO, CPK, CK-MB, and cTnI levels were evaluated in both groups. The effectiveness of these parameters in demonstrating myocardial ischemia during ERCP was investigated. While there were no ECG changes in patients without coronary history, 11 patients (22.9%) had ECG changes that may indicate myocardial ischemia in the ischemic group during ERCP.