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Published on: May 14, 2013
QT Dispersion and Age; Independent Predictors of Restenosis after Percutaneous Coronary Intervention
Naser Aslanabadi, Sirous Vosooghi Moghadam, Babak Kazemi
1Department of Clinical Pharmacy, Faculty of Pharmacy-International Campus, Shohada-ye Haft-e Tir Hospital, Iran University Of Medical Sciences, Tehran, Iran.
Insights
Changes in corrected QT dispersion (QTcd) after percutaneous coronary intervention (PCI) may predict restenosis. Higher QTcd changes and younger age are independent predictors of restenosis following PCI.
Area of Science:
- Cardiology
- Electrophysiology
- Interventional Cardiology
Background:
- Percutaneous coronary interventions (PCIs) lack reliable non-invasive restenosis markers.
- Assessing post-PCI restenosis is crucial for patient outcomes.
Purpose of the Study:
- To evaluate changes in corrected QT interval (QTc), corrected QT dispersion (QTcd), corrected T wave peak to end interval (TPEc), and corrected TPE dispersion (TPEcd) after PCI.
- To determine if restenosis influences these electrocardiographic indices.
Main Methods:
- Analyzed data from 202 patients who underwent successful PCI and subsequent coronary angiography.
- Measured QTc, QTcd, TPEc, and TPEcd before and 24 hours after PCI.
Main Results:
- Median QTc and QTcd significantly decreased post-PCI (p=0.017 and p=0.005, respectively).
- Higher QTcd changes and younger age were independent predictors of restenosis.
- QTcd changes (AUC=0.71) and age (AUC=0.68) showed good predictive performance for restenosis.
Conclusions:
- Significant QTcd changes post-PCI may serve as an inexpensive and simple predictor of restenosis.
- QTcd warrants consideration as a non-invasive electrocardiographic marker for sustained coronary patency after angioplasty.
Introduction:
There are no reliable non-invasive markers of restenosis after Percutaneous Coronary Interventions (PCIs). The aim of our study was to measure changes incorrected QT interval (QTc), corrected QT dispersion (QTcd), corrected T wave peak to end interval (TPEc) and corrected TPE dispersion (TPEcd) after PCI and to determine whether restenosis subsequently affects these indices.
Methods:
From 211 patients, who underwent successful PCI, 202 patients were referred for repeated coronary angiography in order to exclusion of coronary restenosis and included in this analysis. QTc, QTcd, TPEc and TPEcd indices were calculated just before PCI and 24 hours later.
Results:
Comparing pre procedural with post procedural results, median QTc and median QTcd decreased significantly after PCI procedure (from 447 to 440 ms, p=0.017 and from 46 to 40 ms,p=0.005; respectively). Corresponding changes of TPEc and TPEcD were not statistically significant. Multivariate analysis showed higher amounts of QTcd changes [Exp(B): 1.033, 95% CI: 1.018-1.051; P=0.025] and younger age[Exp(B): 1.074, 95% CI: 1.038-1.112; P=0.023] as independent predictors of restenosis. Area under the ROC curve indicated good predictive performance of QTcd changes (.QTcd) [AUC: 0.71, 95% CI: 0.51-0.86, P = 0.03] and age [AUC 0.68, 95% CI 0.62-0.74, p = 0.04] for restenosis after PCI. The best cut-off point for .QTcd was 6 msec, and for age was 52 years. The sensitivity and specificity of .QTcd.6 ms to detect coronary restenosis were 73.2% and 71.4% respectively. The diagnostic accuracy of age was also similar, the sensitivity and specificity of age. 52 years were 68.1% and 74.3% respectively.
Conclusion:
The Higher differences between pre and post PCI QTcd may be an inexpensive and simple predictor of restenosis after a previously successful coronary angioplasty. It seems that these findings encourage us to re-think about using QTcd as a simple ECG predictor for sustained coronary patency after angioplasty.
