Correlation between Tp-ec and QTc with Malignant Arrhythmia after STEMI Coronary Artery Intervention

XIU Ming-wen; GUO Le-ling; HE-miao

doi:10.3969/j.issn.1002-3429.2014.07.050

Abstract：Objective To explore the value of the elevated ST segment resolution (STR), Tp-ec (correction of T wave peak to the time) intermediate stage and Tp-e/ QT ratio changes after percutaneous coronary intervention (PCI) in prediction of malignant arrhythmia induced by acute ST segment elevation myocardial infarction (STEMI). Methods A total of 92 patients with STEMI confirmed by coronary angiography and undergoing PCI therapy within 12 h were selected as observation group, and 88 healthy controls with normal ECG at the same period were chosen as control group. The incidence rate of MAE in observation group was observed within one month of follow-up, and the values of intermediate stages of QTC and Tp-ec and Tp-e/ QT before and after operation were compared; Cox multiple factor regression of correction analysis was performed with numbers of MAE pa-tients in different nodes of intermediate stages of STR, QTc, Tp-ec, and Tp-e/ QT, and risk factors affecting incidence rate of MAE. Results Sixty-four patients had MAE in observation group. The differences in values of QTc, Tp-ec and Tp-e/ QT radio before the operation between related lead with infarction and non-infarction in observation group, and compared with those in control group (P <0. 05), the values of Tp-ec and Tp-e/ QT radio 1 week and 1 month after the operation were decreased, com-pared with the previous period of the same lead (P <0. 05), and the values of non-infarction lead were lower than those of in-farction lead (P <0. 05); non-infarction lead Tp-ec value returned to normal in postoperative 1 month (P <0. 05), but other in-dexes did not return to normal, while the lead values of QTc in postoperative 1 week had returned to normal (P > 0. 05) Cox multiple factor regression analysis showed that the high risk factors of MAE for STEMI patients after PCI operation were QTc≥440 ms, Tp-ec ≥100 ms and Tp-e/ QT ≥0. 25. Conclusion STR, Tp-ec and Tp-e/ QT radio are independent predictors of MAE onset in STEMI patients after PCI therapy, which is valuable for the clinical diagnosis and treatment.