Effect of percutaneous coronary intervention of nonacute total coronary artery occlusions on QT dispersion

Myocardial ischemia is one of several potential causes of increased QT dispersion (QTd) in patients with nonacute total coronary artery occlusions (TCOs). We sought to assess the effect of percutaneous revascularization (PCI) of TCO on QTd and the relationship between QTd and long-term vessel patenc...

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Bibliographic Details
Published in:The American heart journal 2006-02, Vol.151 (2), p.529.e1-529.e6
Main Authors: Goodhart, David M., Hubacek, Jaroslav, Anderson, Todd J., Duff, Hank, Barbeau, Gerald, Ducas, John, Carere, Ronald G., Lazzam, Charles, Dzavik, Vladimir, Buller, Christopher E., Traboulsi, Mouhieddin
Format: Article
Language:English
Subjects:
Angioplasty
Angioplasty, Balloon, Coronary
Cardiology
Coronary Angiography
Coronary Disease - diagnostic imaging
Coronary Disease - physiopathology
Coronary Disease - therapy
Coronary vessels
Electrocardiography
Heart attacks
Humans
Middle Aged
Myocardial Infarction - physiopathology
Time Factors
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Summary:Myocardial ischemia is one of several potential causes of increased QT dispersion (QTd) in patients with nonacute total coronary artery occlusions (TCOs). We sought to assess the effect of percutaneous revascularization (PCI) of TCO on QTd and the relationship between QTd and long-term vessel patency. Seventy patients enrolled in the TOSCA were analyzed. Patients were undergoing PCI of a TCO >72 hours' duration. Two independent reviewers measured QTd from electrocardiograms done immediately before PCI (PRE), 12 to 18 hours after PCI (POST), and then at 6 months (6M). Follow-up angiography was performed at 6 months. Mean QTd decreased from PRE (77 ± 29 milliseconds) to POST (66 ± 26 milliseconds, P < .001) and 6M (65 ± 25 milliseconds, P < .001). Patients with the same or longer QTd at 6 months compared with POST (POST ≤ 6M) had significantly higher risk of failed target-vessel patency (odds ratio 10.3, 95% CI 1.24-84.8) than patients with QTd reduction at 6M versus POST values. Revascularization of TCO resulted in a decrease in QTd, which was sustained at 6M. This suggests that PCI to a TCO has a beneficial effect on stabilization of the underlying ischemic substrate. Furthermore, absence of QTd reduction at 6M versus POST was associated with increased risk of failed target-vessel patency.
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2005.08.010