There are no specific guidelines that dictate when to perform endoscopy in patients after recent myocardial infarction.
Patients with recent myocardial infarction may be at increased risk for cardiopulmonary complications at the time of endoscopy.
Dr Bret Spier and colleagues established the safety of endoscopic procedures performed in 135 patients with recent myocardial infarction based upon specific cardiac risk categories.
|2% had major cardiopulmonary complications during endoscopy|
|Journal of Clinical Gastroenterology|
The team conducted a retrospective analysis of data over 48 months on patients who had an endoscopic procedure performed within 30 days of a myocardial infarction.
Data on chronology of complications and certain cardiac risk categories were collected and analyzed.
The researchers found there was early termination of endoscopic procedures for a major cardiopulmonary complication in 2% of patients.
The complications occurred post myocardial infarction on the day of hospitalization.
The team noted that performance of endoscopic procedures on the day of the myocardial infarction was a risk factor for a procedure-related complication.
The researchers observed ST segment elevation myocardial infarction in 16% of patients.
The team found severely depressed ejection fraction in 22% of patients, and troponin-I peak greater than 1.6 ng/mL in 71% of patients.
No statistically significant increased risk of endoscopy was found in these subsets of patients.
Dr Spier's team concluded, "Endoscopic procedures can be safely performed early post-myocardial infarction without imparting a significant cardiopulmonary risk."
"Timing of endoscopy increases risk of complications."
"However, evidence of significant recent cardiac damage as demonstrated by ST segment elevation does not increase the risk of cardiopulmonary complication. "
"Depressed left ventricular ejection fraction, or troponin-I peak greater than 1.6 ng/mL does not increase risk of cardiopulmonary complication."