Abdelmegid MAKF, Bakr MM, Shams-Eddin H, Youssef AA, Abdel-Galeel A. Effect of reperfusion strategy on QT dispersion in patients with acute myocardial infarction: Impact on in-hospital arrhythmia. World J Cardiol 2023; 15(3): 106-115 [PMID: 37033680 DOI: 10.4330/wjc.v15.i3.106]
Corresponding Author of This Article
Ahmed Abdel-Galeel, MD, PhD, Associate Professor, Department of Cardiovascular Medicine, Assiut University Heart Hospital, Assiut University Street, Assiut 71526, Egypt. ahmed.galeel@aun.edu.eg
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Mar 26, 2023; 15(3): 106-115 Published online Mar 26, 2023. doi: 10.4330/wjc.v15.i3.106
Effect of reperfusion strategy on QT dispersion in patients with acute myocardial infarction: Impact on in-hospital arrhythmia
Mohamed Aboel-Kassem F Abdelmegid, Mohamed M Bakr, Hamdy Shams-Eddin, Amr A Youssef, Ahmed Abdel-Galeel
Mohamed Aboel-Kassem F Abdelmegid, Hamdy Shams-Eddin, Amr A Youssef, Ahmed Abdel-Galeel, Department of Cardiovascular Medicine, Assiut University Heart Hospital, Assiut University, Assiut 71526, Egypt
Mohamed Aboel-Kassem F Abdelmegid, Department of Cardiology, Sohag Heart and GIT Center, Sohag 85264, Egypt
Mohamed M Bakr, Department of Cardiology, Assiut Police Hospital, Assiut 71526, Egypt
Ahmed Abdel-Galeel, Department of Cardiology, Qena General Hospital, Qena 92354, Egypt
Author contributions: Abdelmegid MAF conceived and designed the study; Bakr M collected and analyzed the data; Shams-eddin H drafted the manuscript and performed statistical analysis; Youssef A critically revised and assisted in writing the manuscript; Abdel-Galeel A critically revised and coordinated the submission of the manuscript.
Institutional review board statement: This study was approved by the Committee of Medical Ethics of the Faculty of Medicine, Assiut University (IRB No: 17101454), and complies with the Declaration of Helsinki. Written informed consent was obtained from all participants.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare having no conflicts of interest.
Data sharing statement: All supplementary data related to the current research work are available and ready to be shared upon request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ahmed Abdel-Galeel, MD, PhD, Associate Professor, Department of Cardiovascular Medicine, Assiut University Heart Hospital, Assiut University Street, Assiut 71526, Egypt. ahmed.galeel@aun.edu.eg
Received: December 12, 2022 Peer-review started: December 12, 2022 First decision: January 20, 2023 Revised: January 24, 2023 Accepted: February 22, 2023 Article in press: February 22, 2023 Published online: March 26, 2023 Processing time: 98 Days and 9.4 Hours
Abstract
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
There were significant reductions in QTD and QTcD from admission to 24 hr in both group I and group II patients. QTD and QTcD were found to be shorter in group I patients at 24 hr than those in group II (53 ± 19 msec vs 60 ± 18 msec, P = 0.005 and 60 ± 21 msec vs 69+22 msec, P = 0.003, respectively). The occurrence of in-hospital arrhythmia was significantly more frequent in group II than in group I (25 patients, 20.8% vs 8 patients, 6.7%, P = 0.001). Furthermore, QTD and QTcD were higher in patients with in-hospital arrhythmia than those without (P = 0.001 and P = 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.
Core Tip: We evaluated the effect of a reperfusion strategy on QT dispersion (QTD) and corrected QT dispersion (QTcD) in patients with ST-segment elevation myocardial infarction. Primary percutaneous coronary intervention was found to be superior in the reduction of QTD and QTcD and associated with a lower incidence of in-hospital arrhythmias when compared to fibrinolytic therapy. In addition, QTD and QTcD were shorter in patients not experiencing in-hospital arrhythmia than those with arrhythmia.
