Predictive Value of Tpeak-to-Tend/QT for Early Ventricular Arrhythmias and Arrhythmogenic Death in Patients with Anterior ST Elevation Myocardial Infarction

Abstract

Background: Patients with anterior ST elevation myocardial infarction (STEMI) are vulnerable to life-threatening ventricular arrhythmia and arrhythmic death. This study aimed to investigate the predictive value of Tpeak-to-Tend (TpTe) and TpTe/QT ratio in patients with anterior STEMI on admission for the occurrence of in-hospital life-threatening ventricular arrhythmias and arrhythmic death.

Methods: This observational cross-sectional research was performed on patients with anterior STEMI who showed up within 12 hours of the beginning of symptoms and received the initial percutaneous coronary intervention (pPCI). The primary study endpoints included the assessment of sustained ventricular arrhythmias and all-cause/arrhythmic deaths throughout the hospitalization. Data collection involved clinical history, vital signs monitoring, ECG measurements, LVEF evaluation, and performance of pPCI procedures.

Results: The studied patients had a mean age of 53 ± 11 years. Patients with arrhythmic events displayed a significant rise in QT dispersion, TpTe, TpTe/QT, and arrhythmic death rates (P < 0.05). A multivariate logistic regression examination revealed that HR (with an OR of 1.037 and a 95% CI of 1.004 to 1.071, P = 0.027), TpTe (with an OR of 1.025 and a 95% CI of 1.004 to 1.047, P = 0.022), and TpTe/QT (with an OR of 5.464 and a 95% CI of 2.027 to 14.726, P = 0.001) were found to be significant predictors of arrhythmic events or mortality.

Conclusion: In patients with anterior STEMI, TpTe and TpTe/QT ratio are significant predictors of in-hospital VA and arrhythmic death. Higher TpTe and TpTe/QT values are linked to a higher risk of these occurrences.

Keywords: Arrhythmias; Arythmies; Infarctus du myocarde avec sus-décalage du segment ST; Rapport crête-tendance; Repolarisation ventriculaire; ST Elevation Myocardial Infarction; Tpeak-to-Tend; Ventricular Repolarization.