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Prognostic value of infarct-related-lead Tpeak–Tend/QT ratio in patients with ST-segment elevation myocardial infarction

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Abstract

Tpeak–Tend/QT ratio (Tp–e/QT) in patients with ST-segment elevation myocardial infarction (STEMI) is reportedly associated with major adverse cardiac events (MACEs). However, Tp–e/QT measurement methods are controversial, and few studies have clarified the effect of different Tp–e/QT measures on prognosis. Our study is the first to investigate the advantages of the Tp–e/QT measured by infarct-related-lead method in predicting MACEs during hospitalization and long-term mortality in patients with STEMI. A total of 427 STEMI patients undergoing primary percutaneous coronary intervention (PCI) were included in this study. The Tp–e/QT before PCI was measured by traditional 12-lead method and infarct-related-lead method. Outcomes were tested using comparative statistics, logistic regression, receiver operating characteristic (ROC) curve and Kaplan–Meier survival analysis. There were 62 (14.5%) patients who had MACEs in-hospital. Logistic regression showed that the Tp–e/QT in infarct-related-lead was an independent predictor (p < 0.001). The area under the ROC curve (AUC) of the Tp–e/QT in infarct-related-lead was larger than that in the Tp–e/QT in traditional 12-lead (0.889 vs 0.741), and the optimal cutoff value was 0.32. The three-year survival rate of patients in the infarct-related-lead Tp–e/QT < 0.32 group was better than Tp–e/QT ≥ 0.32 group in Kaplan–Meier survival analysis (93.9 vs 87.0%). When stratified according to infarct-related arteries, the results showed that the common odds ratio of patients in Tp–e/QT ≥ 0.32 group occurred MACEs was 1.562, P = 0.038. The infarct-related-lead Tp–e/QT performed better than the traditional 12-lead Tp–e/QT in predicting poor prognosis.

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Acknowledgements

We thank the people who helped us in this study.

Funding

The present study was supported by grants from Major Project of Natural Science Research of Colleges and Universities in Anhui Province [Grant Number KJ2019ZD65] and Anhui Provincial Postdoctoral Science Foundation [Grant Number 2016B097].

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Authors and Affiliations

  1. Department of Electrocardiogram Diagnosis, The Second Affiliated Hospital, Anhui Medical University, Hefei, 230060, Anhui, China

    Yue-e Wu & Lan Ma

  2. Department of Cardiology, The First Affiliated Hospital, Anhui Medical University, Hefei, 230022, Anhui, China

    Ze-ping Hu

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  1. Yue-e Wu
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YW and ZH conceived the study. YW and LM searched the databases and extracted the data. YW and ZH analyzed the data. YW wrote the draft of the paper. ZH and LM reviewed the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ze-ping Hu.

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Wu, Ye., Ma, L. & Hu, Zp. Prognostic value of infarct-related-lead Tpeak–Tend/QT ratio in patients with ST-segment elevation myocardial infarction. Heart Vessels 37, 539–548 (2022). https://doi.org/10.1007/s00380-021-01950-8

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