FREQUENCY OF ACUTE MYOCARDIAL INJURY AMONG PATIENTS PRESENTING WITH UPPER GASTROINTESTINAL BLEEDING: A CROSS-SECTIONAL STUDY FROM PESHAWAR, PAKISTAN

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a common medical emergency with significant morbidity and mortality. Acute myocardial injury may occur in UGIB due to hemodynamic compromise and is commonly identified using elevated cardiac troponin levels.

Objective: To determine the frequency of acute myocardial injury among patients presenting with UGIB and its association with demographic and clinical variables.

Material and Methods: A cross-sectional study was conducted in the Department of Medicine at Khyber Teaching Hospital, Peshawar, from 11 January 2024 to 11 July 2024. A total of 163 patients aged 20–80 years presenting with UGIB were enrolled using consecutive non-probability sampling. Patients with pre-existing cardiac disease were excluded. Cardiac troponin I levels were measured twice, 12 hours apart, and acute myocardial injury was defined as troponin I >0.2 ng/mL. Data were analyzed using SPSS version 23. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. The Chi-square test was used to assess associations, with p ≤0.05 considered statistically significant.

Results: The mean age of patients was 58 ± 11.5 years. Among the 163 patients, 108 (66%) were male and 55 (34%) were female. Acute myocardial injury was observed in 13 patients (8%), while 150 patients (92%) had normal troponin I levels. No statistically significant association were identified between myocardial injury and age (p = 0.6878) or gender (p = 0.8131).

Conclusion: Acute myocardial injury was identified in 8% of patients presenting with upper gastrointestinal bleeding. Although no statistically significant association was observed with age or gender, myocardial injury remains a clinically important consideration in UGIB. Selective