Abstract Body: Background:
Acute pancreatitis (AP) is a systemic inflammatory condition that is increasingly recognized to have cardiovascular consequences. While individual studies have shown cardiac problems, the overall load, risk profile, and clinical consequences are unknown. Given the high prevalence of hypertension and associated comorbidities in AP patients, this meta-analysis aims to quantify the frequency of cardiovascular events while also investigating critical determinants and outcomes.

Methods:
A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Studies reporting cardiovascular complications in AP were included. Primary outcomes were the incidence of myocardial infarction (MI), arrhythmia, and other cardiac events. Pooled hazard ratios (HRs), odds ratios (ORs), and mean differences were calculated using a random-effects model. Heterogeneity was assessed using the I square statistic.

Results:
Seventeen trials with about 64,000 AP patients were examined. Cardiovascular problems occurred in 22.4% of patients, with ECG abnormalities detected in up to 48%. The overall incidence of MI varied from 1.2% to 14.5%. Hypertension (HR 1.45; 95% CI: 1.41-1.50), diabetes (HR 1.32; 95% CI: 1.27-1.37), and chronic kidney disease (HR 1.75; 95% CI: 1.68-1.82) all increased cardiovascular risk. Cardiac problems were associated with higher in-hospital mortality (OR 2.84; 95% CI: 2.72-2.97) and longer hospital stays (mean difference: +3.2 days; 95% CI: 3.0-3.4).


Conclusion:
Cardiovascular consequences are common and clinically significant in acute pancreatitis, especially in those with hypertension, diabetes, or kidney disease. Early cardiovascular monitoring might reduce mortality and resource use. These results highlight the relationship between systemic inflammation and hypertension comorbidities, emphasizing the significance of integrated cardio-gastroenterology care pathways and future research to uncover effective therapeutics for cardioprotection in AP.