The prognostic value of the Tpeak-Tend interval in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

• Published in: Journal of electrocardiology 2009-11, Vol.42 (6), p.555-560
• Main Authors: Haarmark, Christian, MD, Hansen, Peter R., MD, PhD, Vedel-Larsen, Esben, MScEng, Haahr Pedersen, Sune, MD, Graff, Claus, MScEng, Andersen, Mads P., MScEng, Toft, Egon, MD, PhD, Wang, Fan, MD, Struijk, Johannes J., MScEng, PhD, Kanters, Jørgen K., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angioplasty, Balloon, Coronary - mortality; Angioplasty, Balloon, Coronary - utilization; Cardiovascular; Denmark; Electrocardiography - methods; Electrocardiography - statistics & numerical data; Female; Humans; Incidence; Male; Middle Aged; mortality; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - surgery; Percutaneous coronary intervention; Prognosis; QT interval; Reproducibility of Results; Risk Assessment - methods; Risk Factors; Sensitivity and Specificity; ST-segment elevation myocardial infarction; Survival Analysis; Survival Rate; Tpeak-Tend interval; Treatment Outcome
• ISSN: 0022-0736; 1532-8430
• DOI: 10.1016/j.jelectrocard.2009.06.009

Abstract Introduction The Tpeak-Tend interval (TpTe) has been linked to increased arrhythmic risk. TpTe was investigated before and after primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI). Method Patients with first-time STEMI treated with pPCI were included (n = 101; mean age 62 years; range 39-89 years; 74% men). Digital electrocardiograms were taken pre- and post-PCI, respectively. Tpeak-Tend interval was measured in leads with limited ST-segment deviation. The primary end point was all-cause mortality during 22 ± 7 months (mean ± SD) of follow-up. Results Pre- and post-PCI TpTe were 104 milliseconds [98-109 milliseconds] and 106 milliseconds [99-112 milliseconds], respectively (mean [95% confidence interval], P = .59). A prolonged pre-PCI TpTe was associated with increased mortality (hazard ratio, 10.5 [1.7-20.4] for a cutoff value of 100 milliseconds). Uncorrected QT and heart rate–corrected QT intervals (Fridericia-corrected QT) were prolonged after PCI (QT: 401 vs 410 milliseconds, P = .022, and Fridericia-corrected QT: 430 vs 448 milliseconds, P < .0001). Conclusion In patients with STEMI undergoing pPCI, pre-PCI TpTe predicted subsequent all-cause mortality, and the QT interval was increased after the procedure.