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CKMB Role as Cardiac Toxicity Prognostic Marker in Acute Organophosphorus Poisoning

Vinay Kumar K, Assistant Professor, Department of Cardiology, JSS Medical College, Mysore, Karnataka 570015, India. , Ravishankar M.S. , & Vinay Kumar K. ,

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Journal of Cardiovascular Medicine and Surgery 4(2):p 84-87, April-June 2018. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4218.2

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Abstract

Introduction: Acute Organ phosphorous compound (OPC) poisoning is an important indication for emergency admission in most hospitals throughout India. Cardiac complications that often accompany poisoning with these compounds may be serious and are often fatal. These complications are preventable, if they are recognized early and treated adequately. Objectives of the study is to assess the cardiac toxicity in Organ phosphorous compound poisoning and to associate electrocardiogram changes and CKMB levels among Organ phosphorous compound poisoning patients.

Materials and methods: A hospital based observational study among 37 adult patients who presented to emergency department of tertiary care centre with Organ phosphorous Compound Poisoning. Informed consent and institutional ethical clearance was obtained before study. Electrocardiography (ECG) was done, plasma Pseudocholiesterase levels and CKMB levels were measured. Outcome measures considered were recovery or death. Post mortem Histopathological findings of cardia were recorded.

Results: In the study 37 adult patients with OP poisoning were included. Mortality rate was 8.1% (3). Significant association was observed between outcome and CKMB levels. All the patients who mortality had significantly higher levels of CKMB compared to others. There was also significant association between outcome and ECG changes. Out of 3 patients who died 2 had abnormal ECG changes. All the patients who died had consumed chlorpyriphos compound. Histopathological findings of heart in all the subjects who had mortality showed myocardial interstitial edema, vascular congestion and Patchy interstitial inflammation and one showed patchy myocarditis with other findings.

Conclusion: Patients with organophorphorus compound poisoning should beevaluated for electrocardiogram along with CKMB which helps in predicting cardiac toxicity and can be considered as a surrogate prognostic marker.


 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4218.2

Keywords

Organ Phosphorus Compound (OPC) Poisoning; Cardiac Toxicity; Electrocardiographical Abnormalities; CKMB.

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