Electrocardiographic measures of ventricular repolarization dispersion and arrhythmic outcomes among ST elevation myocardial infarction patients with pre‐infarction angina undergoing primary percutaneous coronary intervention

Abstract

Background: Arrhythmias are considered one of the major causes of death in ST elevation myocardial infarction (STEMI), particularly in the early in-hospital phase. Preinfarction angina (PIA) has been suggested to have a protective role. Objectives:To study the difference in acute electrocardiographic findings between STEMI patients with and without PIA and to assess the in-hospital arrhythmias in both groups. Material and Methods: We prospectively enrolled 238 consecutive patients with STEMI. Patients were divided into two groups: those with or without PIA. ECG data recorded and analyzed included ST-segment resolution (STR) at 90 min, corrected QT interval (QTc) and dispersion (QTD), T-peak-to-T-end interval (Tp-Te), and dispersion and Tp-Te/QT ratio. In-hospital ventricular arrhythmias encountered in both groups were recorded. Predictors of in-hospital arrhythmias were assessed among different clinical and electrocardiographic parameters. Results: Of the 238 patients included, 42 (17%) had PIA and 196 (83%) had no PIA.Patients with PIA had higher rates of STR (p < 0.0001), while patients with no PIA had higher values of QTc (p = 0.006), QTD (p = 0.001), Tp-Te interval (p = 0.001), Tp-Te dispersion (p < 0.0001), and Tp-Te/QT ratio (p = 0.01) compared to those with angina preceding their incident infarction (PIA). This was reflected into significantly higher rates of in-hospital arrhythmias among patients with no PIA (20% vs. 7%, p = 0.04). Furthermore, longer Tp-Te interval and higher Tp-Te/QT ratio independently predicted in-hospital ventricular arrhythmias. Conclusion:Pre-infarction angina patients had better electrocardiographic measures of repolarization dispersion and encountered significantly less arrhythmic events compared to patients who did not experience PIA.

Tpeak‐Tend ECG Marker in Obesity and Cardiovascular Diseases: A Comprehensive Review

“…An analysis according to preinfarction angina (PIA) was conducted and revealed that STEMI patients with PIA had a lower chance of suffering from VA than those without PIA–who had longer Tp-e, Tp-e/QT ratio, which independently predicted in-hospital VA [ 98 ]. Interestingly, Tp-e was found to predict Intensive Care Unit (ICU) stay among patients with acute coronary syndrome (ACS) with COVID-19 [ 99 ].…”

Factors Influencing Time to First Medical Contact in Patients with Acute ST-Segment Elevation Myocardial Infarction: A Retrospective Analysis

“…Elderly patients are more likely to ignore their symptoms [ 19 ]. Research shows that compared to patients without pain, not only thrombolytic treatment, patients with pre-infarction angina (PIA) have better in-hospital outcomes after PCI treatment [ 20 ]. Our study suggests that persistent chest tightness/pain is a protective factor of S2FMC, as continuous discomfort can attract patients’ attention and thereby shorten the S2FMC.…”

The Effect of Percutaneous Coronary Intervention on QT Dispersion and the Association Between Them: A Systematic Review

“…PCI: percutaneous coronary intervention, STEMI: ST-elevation myocardial infarction, PIA: postinfarction angina, QTd: QT dispersion, QTc: corrected QT, STR: ST-segment resolution, Tp-Te: T-peak-to-T-end interval, PTCA: percutaneous transluminal coronary angioplasty, HRV: heart rate variability, AMI: acute myocardial infarction, TPE: T-wave peak to end, CABG: coronary artery bypass graft, SK: streptokinase[19][20][21][22][23][24][25][26][27][28][29][30] …”