QT Dispersion and Age; Independent Predictors of Restenosis after Percutaneous Coronary Intervention
2017
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 QTcd6 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.
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