Key result
PPCI is linked to greater QTD and QTcD reductions and fewer in-hospital arrhythmias versus fibrinolytics.
Why the study?
STEMI increases QT dispersion and corrected QT dispersion, which associate with ventricular arrhythmia, but the comparative impact of different reperfusion strategies on these parameters and in-hospital arrhythmia required evaluation.
Does primary percutaneous coronary intervention reduce QT dispersion and in-hospital arrhythmia compared to fibrinolytic therapy in patients with STEMI?
Observational (n=240)
Yes
Does primary percutaneous coronary intervention reduce QT dispersion and in-hospital arrhythmia compared to fibrinolytic therapy in patients with STEMI?
p-value: p=0.02
In STEMI patients, primary percutaneous coronary intervention provides greater reductions in QT dispersion and lower rates of in-hospital arrhythmias compared to fibrinolytic therapy.
May support PPCI preference in STEMI for arrhythmia reduction; leaves open need for randomized confirmation of QT dispersion effects.
BACKGROUND: Myocardial ischemia and ST-elevation myocardial infarction (STEMI) increase QT dispersion (QTD) and corrected QT dispersion (QTcD), and are also associated with ventricular arrhythmia. AIM: To evaluate the effects of reperfusion strategy [primary percutaneous coronary intervention (PPCI) or fibrinolytic therapy] on QTD and QTcD in STEMI patients and assess the impact of the chosen strategy on the occurrence of in-hospital arrhythmia. METHODS: This prospective, observational, multicenter study included 240 patients admitted with STEMI who were treated with either PPCI (group I) or fibrinolytic therapy (group II). QTD and QTcD were measured on admission and 24 hr after reperfusion, and patients were observed to detect in-hospital arrhythmia. RESULTS: 0.02, respectively). CONCLUSION: In STEMI patients, PPCI and fibrinolytic therapy effectively reduced QTD and QTcD, with a higher observed reduction using PPCI. PPCI was associated with a lower incidence of in-hospital arrhythmia than fibrinolytic therapy. In addition, QTD and QTcD were shorter in patients not experiencing in-hospital arrhythmia than those with arrhythmia.
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Abdelmegid et al. (2023) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=240). Primary percutaneous coronary intervention (PPCI) vs. Fibrinolytic therapy was evaluated on QT dispersion (QTD), corrected QT dispersion (QTcD), and in-hospital arrhythmia (p=0.02). Primary percutaneous coronary intervention (PPCI) was associated with a greater reduction in QTD and QTcD and a lower incidence of in-hospital arrhythmia compared to fibrinolytic therapy (P=0.02).
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