Abstract
BackgroundQT dispersion (QTD) represents inhomogeneous ventricular repolarization such that an increased QTD may predispose the heart to malignant ventricular arrhythmias (VAs). This study was conducted to compare QTD in patients with ST-elevation myocardial infarction (STEMI) before and after treatment by streptokinase (SK) versus primary percutaneous coronary intervention (PCI).MethodsThe present case–control study was conducted on 185 STEMI patients who received SK (115 cases) or underwent primary PCI (70 cases). QTD and QT corrected dispersion before and 24 h after treatment. Likewise, they were also found to correct fatal arrhythmias (VT and VF) during the first 24 h after admission, and ejection fraction (EF) 24 h after treatment was evaluated.ResultsQTD decreased in the primary PCI group, though no significant difference was seen between the two studied groups (P > 0.05). A significant increase was detected in the EF mean values for the primary PCI-treated patients (P = 0.022). Moreover, there was a significant reduction in QTD of patients with fatal arrhythmias in the primary PCI group (P = 0.022).ConclusionAn overall QTD reduction in the primary PCI group and a significant decrease in QTD of patients with fatal arrhythmias in the primary PCI group show that this treatment strategy is more efficient than thrombolytic therapy. As an important indicator of proper myocardial function, EF can independently predict improved myocardial function in the primary PCI group.
Highlights
Acute myocardial infarction (AMI) is one of the most prevalent and life-threatening diseases worldwide
Continuous variables were reported as mean ± standard deviation (M ± Standard deviation (SD)), and categorical variables were presented as number PCI percutaneous coronary intervention, SK streptokinase, STEM ST-elevation myocardial infarction, Coronary artery disease (CAD) coronary artery disease, EF ejection fraction Statistical significance where p < 0.05 * Comparison between the two groups
The findings revealed that there was no significant difference in QT dispersion (QTD) mean values of patients with ST-elevation myocardial infarction (STEMI) before and after being treated by streptokinase compared to those under treatment by primary PCI
Summary
Acute myocardial infarction (AMI) is one of the most prevalent and life-threatening diseases worldwide. Defined as the difference between the longest (QTmax) and the shortest (QTmin) QT intervals within a 12‐lead ECG, QT interval dispersion (QTD) is presently regarded as a diagnostic criterion for a cardiac autonomic tone which can be altered during ischemia. It is, an indicator of ventricular depolarization, accompanied by an increased risk of cardiac arrhythmia and sudden death in more severe stages. This study was conducted to compare QTD in patients with ST-elevation myocardial infarction (STEMI) before and after treatment by streptokinase (SK) versus primary percutaneous coronary intervention (PCI)
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