Admission Tpe interval predicts reperfusion success in STEMI patients treated with fibrinolytic agents

Abstract

Objective: Myocardial infarction is a leading cause of morbidity and mortality. Fibrinolytic administration is still a life-saving choice in ST-segment elevated myocardial infarction (STEMI), but the rate of successful reperfusion can be inconsistent. Failed reperfusion adds additional clinical risks to rescue percutaneous coronary intervention for STEMI patients. The interval between the peak of the T wave and the end of the T wave (Tpe) and the ratio of Tpe and a corrected measurement of the time from the start of the Q wave to the end of the T wave (Tpe/QTc ratio) are relatively new electrocardiogram (ECG) indices and have not yet been tested in STEMI patients treated with fibrinolytic agents. Methods: A total of 177 STEMI patients (mean age: 60.5+-11.1 years; 138 men and 39 women) were enrolled in this retrospective study to evaluate ECG parameters. The Tpe interval and the Tpe/QTc ratio at baseline and at the 90th minute following the administration of fibrinolytic therapy were analyzed. The clinical and ECG findings of successful and failed reperfusion groups were compared. Results: Successful reperfusion was achieved in 119 patients (67.2%). The average Tpe interval on the admission ECG was shorter (91.7 vs. 100.9 milliseconds [ms]) (p<0.001) and shortened more in the successful reperfusion group (9.3 vs. 4.5 ms) (p<0.001). A cut-off value of 89.0 ms for the Tpe interval on the admission ECG was found to be related to reperfusion success with a sensitivity of 90.9%. Conclusion: The Tpe interval was a predictor for reperfusion success in STEMI patients treated with fibrinolytic agents.

Keywords

• fibrinolytic administration
• reperfusion success; st-segment elevation myocardial infarction; tpe interval.