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
ARTICLE HIGHLIGHTS
Research background
ST-elevation myocardial infarction (STEMI) increases QT dispersion (QTD) and corrected QT dispersion (QTcD), and is also associated with ventricular arrhythmia. Fibrinolytic therapy or primary percutaneous coronary intervention (PPCI) was used as the reperfusion strategy in acute STEMI patients.
Research motivation
Cardiac arrhythmia in the setting of acute myocardial infarction (MI) has serious impact on patient morbidity and mortality. Every effort should be made to prevent post-MI arrhythmia and to predict its occurrence as early as possible.
Research objectives
To compare the impact of revascularization with fibrinolysis or PPCI in STEMI patients on cardiac electrical stability, as indicated by QTD and QTcD measurements.
Research methods
Two groups of patients were treated for acute STEMI; 1 group of patients were treated with fibrinolysis, and the other group of patients were treated with PPCI. QTD and QTcD were measured at baseline and at 24 hr following successful reperfusion. We compared these measures between the two groups and observed all patients for incidence of arrhythmia during hospital admission.
Research results
There were significant reductions in QTD and QTcD at 24 hr in both study groups. QTD and QTcD were found to be shorter in group I at 24 hr than in group II. Moreover, the incidence of in-hospital arrhythmia was significantly higher in group II as compared to group I.
Research conclusions
In STEMI patients, both PPCI and fibrinolytic therapy effectively reduced QTD and QTcD, with a more significant reduction observed after PPCI. Furthermore, PPCI was associated with a lower incidence of in-hospital arrhythmia.
Research perspectives
PPCI was superior to fibrinolytic therapy with respect to the electrical stability of the heart.
