Effect of different anti-platelet therapies on QT dispersion in patients with acute coronary syndrome after percutaneous coronary intervention

Abstract

Objective To investigate the effect of anti-platelet therapy on QT dispersion(Qtd, QTcd) in patients with acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI). Methods 80 patients with ACS and undergoing PCI were divided into the control group and the observation group by the random number table method, 40 cases in each group.The control group was treated with routine antiplatelet therapy, oral administration of aspirin and clopidogrel, while the observation group was treated with intensive antiplatelet therapy and tirofiban based on the treatment in the control group.The changes of platelet aggregation function and inflammation indices before and after treatment were compared between the two groups.The changes of QT dispersion in the two groups were monitored by electrocardiogram.Both two groups were followed up for 1 year, and the incidence rate of adverse events was analyzed statistically. Results Before treatment, there were no significant differences in platelet aggregation indices (MPAR, PRU), levels of inflammatory factors (hs-CRP, sCD40L) and QT dispersion between the two groups (all P>0.05). After treatment, MPAR and PRU in the observation group were lower than those in the control group[(30.26±8.42)%, (114.36±10.26)U vs.(39.33±9.4)%, (143.86±12.65)U](t=4.542, 11.454, all P<0.05), the levels of hs-CRP and sCD40L were lower than those in the control group[(2.12±0.62 )mg/L, (1.71±0.94)μg/L vs.(2.94±0.44)mg/L, (2.76±1.23)μg/L](t=6.748, 4.289, all P<0.05), and QTd and QTcd were also lower than those in the control group[(25.41±3.32)ms, (26.12±4.26)ms vs.(29.52±2.98)ms, (30.51±3.97)ms](t=5.826, 4.768, all P<0.05). During the follow-up, the incidence rate of restenosis or thrombosis in stent of the observation group was lower than that of the control group (2.50% vs.15.00%) (χ2=3.913, P<0.05). Conclusion The application of tirofiban anti-platelet therapy in patients with ACS after PCI can reduce the inflammatory responses, reduce platelet aggregation rate, shorten QT dispersion and reduce the incidence of adverse events. Key words: Acute coronary syndrome; Percutaneous coronary intervention; Tirofiban; QT dispersion