Chronic pancreatitis and the heart disease: Still terra incognita?

Table 1 Studies on pancreatic exocrine insufficiency in patients with chronic heart failure

Ref.	n	Mean age (yr)	Method used	PEI (%)
Xia et al[17], 2017, China	All patients: 104 (85.6% males)	70.4	FE-1	All patients: n = 59 (56.7%)
				NYHA I-II: Mild/moderate: n = 7, severe: n = 1; NYHA III: Mild/moderate: n = 15, severe: n = 14; NYHA IV: Mild/moderate: n = 10, severe: n = 12
	NYHA I/II: 32
	NYHA III: 42
	NYHA IV: 30
Vujasinovicet al[18], 2016, Slovenia	All patients: 87 (64.4% males)	74.7	FE-1	All patients: n = 6 (6.9%), mild/moderate PEI: n = 3, severe PEI: n = 3, NYHA II: n = 3, NYHA III: n = 3
	NYHA II: 54
	NYHA III: 33
Özcan et al[19], 2015, Turkey	All patients: 52 (61,5% males)	67.5	FE-1	All patients: n = 21 (40.4%)
				NYHA I/II: Mild/moderate PEI: n = 3, severe PEI: n = 4
	NYHA I/II: 32
	NYHA III/IV: 20			NYHA III/IV: Mild/moderate PEI: n = 4, severe PEI: n = 10

n: Number of patients; FE-1: Fecal elastase-1; PEI: Pancreatic exocrine insufficiency; NYHA: New York Heart Association classification.

Table 2 Studies on cardiovascular diseases in patients with chronic pancreatitis

Ref.	n	Mean age (yr)	Results
Tuzhilin et al[20], 1975, Union of Soviet Socialist Republics/United States	98	Not reported	Marked correlation between the clinical symptoms in CP and chronic coronary insufficiency
			Pancreatic enzymes and their inhibitors profoundly affected blood coagulability and appear to influence the course of pancreatic inflammation
Gullo et al[5], 1982, Italy	54	44.2	Arterial lesions were found in 18 patients (33.3%) and in five controls (9.3%) (P < 0.01)
	49 (90.7%) males
			No differences were found between the two groups for arterial hypertension, smoking habits, or blood lipid abnormalities
Hsu et al[6], 2016, Taiwan	17405	48.3	The overall incidence of acute coronary syndrome was 2.15-fold higher in the CP cohort than in the non-CP cohort (4.89 vs 2.28 per 10,000 person-years) with an adjusted hazard ratio of 1.40 (95% confidence interval 1.20-1.64)
	14418 (82.8%) males
			Compared with individuals without CP, patients with CP aged ≤ 39 years exhibited the highest risk of acute coronary syndrome
			CP may become an independent risk factor for acute coronary syndrome
Lee et al[21], 2018, United States	32	61.7	Statistically significant association between a diagnosis of alcohol-related CP and diabetes mellitus, and the presence of an atheroma (calcified carotid artery plaques) on the panoramic image, in comparison with the rate manifested by the historical general population cohort (25% vs 3%; P < 0.05)
	(100%) males
de la Iglesia et al[4], 2018, Spain	430	47.8	Together with known major cardiovascular risk factors like smoking and hypertension, pancreatic exocrine insufficiency is significantly associated with the increased risk of cardiovascular events in patients with CP
	340 (79%) males

CP: Chronic pancreatitis.