Turk Kardiyol Dern Ars. Ahead of Print: TKDA-84789 | DOI: 10.5543/tkda.2019.84789
Admission Tpe interval predicts the reperfusion success in STEMI patients treated with fibrinolytic agents
, Sinan Akıncı1
, Mehmet Hüsamettin Akküçük2
, Cihan Altın3
, Haldun Müderrisoğlu41
Department of Cardiology, Başkent University Medical Faculty Alanya Application and Research Center, Alanya2
Department of Emergency Medicine, Başkent University Medical Faculty Alanya Application and Research Center, Alanya3
Department of Cardiology, Başkent University Medical Faculty İzmir Zübeyde Hanım Application and Research Center, İzmir4
Department of Cardiology, Başkent University Medical Faculty, Ankara
OBJECTIVES Myocardial infarction is the leading cause of morbidity and mortality in the modern era. Fibrinolytic administration is still a life-saving choice in ST-segment elevated myocardial infarction (STEMI) but rates of successful reperfusion can be inconsistent. Failed reperfusion carries additional clinical risks during rescue percutaneous coronary intervention (PCI) for STEMI patients. Tpe interval and Tpe/QTc ratio are novel electrocardiographic (ECG) indices and have never been tested in STEMI patients treated with fibrinolytic agents.
METHODS We enrolled 177 STEMI patients (mean age 60.5±11.1 years: 138 men and 39 women) into the study population and ECG parameters were evaluated retrospectively. We searched for Tpe interval and Tpe/QTc ratios at baseline and at 90th minutes following fibrinolytic administration. We compared clinical and ECG findings between successful and failed reperfusion groups.
RESULTS Successful reperfusion has been achieved in 119 patients (67.2%). Average Tpe interval on admission ECG was shorter (91.7 vs. 100.9ms) (p<0.001) and shortened more in successful reperfusion group (9.3 vs. 4.5ms) (p<0.001). A cut-off value of 89.0ms for Tpe interval on admission ECG was found to be related to reperfusion success with a sensitivity of 90.9%.
CONCLUSION Tpe interval can be a predictor for reperfusion success in STEMI patients treated with fibrinolytic agents.
ST-segment elevation MI, Tpe interval, fibrinolytic administration, reperfusion success
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Corresponding Author: Ali Çoner, Türkiye