Predictive Value of QT Dispersion Changes on Prognostic Outcomes After Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

SHANGGUAN Jiangyuan; LU Xiujuan

doi:10.13919/j.issn.2095-6274.ZHJY202504039

Abstract：Objective To investigate the temporal evolution of QT dispersion(QTd)following emergen-cy percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI),and to assess its predictive value for clinical outcomes.Methods A total of 128 AMI patients who underwent emergency PCI at Longyan Second Hospital between January 2023 and December 2024 were enrolled.Based on the occurrence of major adverse cardiovascular events(MACE)within 30 days post-PCI,patients were categorized into a MACE group(n=42)and a non-MACE group(n=86).An additional 40 individuals with normal coronary angiography find-ings during the same period were included as the control group.QTd values were compared between the AMI group(pre-and post-PCI)and the control group,as well as between MACE and non-MACE patients at multiple post-PCI time points.Risk factors for MACE were identified and the predictive efficacy of QTd was evaluated.Re-sults Pre-PCI QTd in the AMI group was significantly higher than that of the control group(P＜0.001).After PCI,QTd decreased progressively over time(24h＞48h＞72h＞7d),yet remained significantly higher than that of the control group at each corresponding time point(all P＜0.001).QTd values at 24h,48h,72h,and 7 days post-PCI were significantly higher in the MACE group compared to the non-MACE group(P＜0.05 for all).Univariate analysis revealed that patients in the MACE group were older(P=0.002),had higher QTd(P＜0.001),a greater incidence of fragmented QRS(fQRS)on ECG(P=0.001),and lower left ventricular ejection fraction(LVEF)(P=0.001)than those in the non-MACE group.Multivariate logistic regression identified elevated QTd,presence of fQRS,and reduced LVEF as independent risk factors for MACE after emergency PCI in AMI patients(P＜0.05).The area under the ROC curve(AUC)for QTd in predicting MACE was 0.831,with a sensitivity of 76.82％and specificity of 81.61％,outperforming both fQRS and LVEF.Conclusion QT dispersion is a valuable and reliable predictor of MACE following emergency PCI in patients with AMI.It demonstrates superior sensitivity and specificity and may serve as a key electrocardiographic indicator for early risk stratification and prognosis evaluation.