The changes and significance of Tp-ec and Tp-e/QT ratio in pateints with STEMI after emergency PCI

doi:10.3969/j.issn.1002-7386.2017.01.004

Abstract：Objective To investigate the dynamic changes of Tp-ec and Tp-e/QT ratio in pateints with ST-segment elevation myocardial infarction ( STEMI ) after emergency percutaneous coronary intervention ( PCI ) , and to explore its diagnostic value for malignant arrhythmia .Methods The Tp-ec and Tp-e/QT ratio in 75 patients with STEMI ( observation group) before and after PCI and in different time points during two weeks in different leads were observed and compared with those of 65 healthy volunteers (control group).The dynamic changes of Tp-ec,Tp-e/QT ratio during 24h after PCI were recorded by using 24h ambulatory electrocardiography .Moreover the malignant arrhythmia events ( MAE) within one month after PCI were followed up .Results The Tp-ec and Tp-e/QT ratio in patients with MAE were significantly longer than those in patients without MAE ( P <0.05).The Tp-ec/QT ratio was obviously decreased indifferent time points during 24h after PCI in MAE group and non-MAE group,moreover,which reached the lowest point at 3~4 hours after PCI.The Tp-e/QT ratio in every hour in MAE group was obviously higher than that in non-MAE group.The Tp-ec and Tp-e/QT ratio in infarction-related leads and non-infarction related leads in observation group before PCI were significantly higher than those in control group ( P <0.05),however,the Tp-ec and Tp-e/QT ratio on 24 hours and 2 weeks after PCI were significantly lower than those at the same leads in former time points ( P <0.05),moreover, there were significant differences in the related leads in different time points between infarction -related leads and non-infarction related leads ( P <0.05).The Tp-ec was recovered to normal status on 2 weeks after PCI ,but the other electrocardio -indexes in observation groups were significantly higher than those in control group ( P <0.05).Conclusion The Tp-ec,especially Tp-e/QT ratio may be regarded as a promising noninvasive electrocardio-index to predict MAE occurrence in patients with STEMI and to evaluate patient ' s prognosis after PCI.