QTc intervals in acute myocardial infarction: first-year prognostic implications

Corrected QT (QTc) intervals were measured retrospectively in 160 consecutive survivors of acute myocardial infarction under 66 years of age. Calculations were made the first 2 d in the coronary care unit (CCU), the first post-CCU day, at discharge, and at 1-3, 6, and 12 months after discharge. All patients were in sinus rhythm and without bundle branch block at discharge from the hospital. Sixteen patients died during the first follow-up year. Twenty patients suffered a reinfarction, five of whom died. The highest QTc values were registered in the CCU and the lowest at the 1-year control. Patients with subendocardial infarcts had longer QTc intervals than those with transmural infarcts, especially during the acute phase. Patients with inferior infarcts had shorter QTc intervals during the CCU period. Those who reinfarcted or died a cardiac death (particularly when sudden) during the follow-up year had longer QTc intervals during the post-CCU phase. A multivariate analysis of risk factors revealed that the QTc interval at discharge was of significant independent value for predicting major cardiac events after discharge from the hospital. It is concluded that repeated measurements of QTc may be of value when assessing prognosis after acute myocardial infarction.