Early Qtc Interval Prolongation After Primary Percutaneous Coronary Intervention May Have a Positive Impact

Abstract

Objectives: Corrected QT (QTc) interval is prolonged in acute myocardial infarction and begins to shorten after successful reperfusion. Data on the early change of QTc after reperfusion and the prognostic significance of this change are limited. We aimed to evaluate the change of QTc interval in the first hour following successful primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI) patients and its relationship with reperfusion parameters such as myocardial blush grade (MBG) and ST-segment resolution (STR%). Materials and Methods: Patients who presented with the first STEMI episode and underwent successful pPCI were included in the study. After pPCI, MBG and STR% were calculated. QTc measurements were made from the electrocardiography (ECG) recorded at admission (Pre-pPCI QTc), 1 hour after pPCI (Post-pPCI QTc), and the 24th hour. Results: One hundred and five patients who had successful pPCI with adequate ECG data were enrolled in the study. The mean Pre-pPCI QTc was 409±34 ms, and the mean post-pPCI QTc was 427±32 ms. A statistically significant prolongation was observed in the QTc interval after pPCI (QTc-Change) [21 ms (-3, 37 interquartile range (IQR)), p<0.001]. The median STR was 71% (60-83 IQR), and the median MBG was 2 (1-3 IQR). In the multivariable linear regression analysis, a significant relationship was observed between QTc-Change with MBG and STR%Conclusion: It was found that the QTc interval continued to prolong somewhat in the early period after successful pPCI in STEMI patients, and this QTc-Change was significantly associated with reperfusion parameters such as MBG and STR%. STR% and MBG were higher in those with higher QTc-Change.