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Archivos de cardiología de México
versión On-line ISSN 1665-1731versión impresa ISSN 1405-9940
Resumen
ROMAN-GUZMAN, Rodolfo M. et al. Shortening in the Tp-e/QTc ratio after angioplasty in patients with acute coronary syndrome. Arch. Cardiol. Méx. [online]. 2020, vol.90, n.4, pp.452-466. Epub 10-Feb-2021. ISSN 1665-1731. https://doi.org/10.24875/acm.20000010.
Objective:
Transmural Dispersion of Repolarization (TDR) is a Risk factor for Death in patients with Acute Coronary Syndrome (ACS). In order to know the effect of angioplasty on TDR, the Tp-e/QTc ratio was studied in patients with ACS undergoing angioplasty.
Method:
An observational, retrospective and descriptive study was designed. 150 patients (N = 150) with diagnosis of ACS were included. The initial Tp-e/QTc ratio was assessed and then its post-angioplasty shortening was evaluated. As a secondary objective, we compared the association of these Tp-e/QTc ratio changes with cardiovascular mortality and cardiovascular adverse events.
Results:
The average in the initial Tp-e/QTc ratio was 0.2529, while post-angioplasty was 0.2397. Through a Wilcoxon rage test, a significant decrease in the Tp-e/QTc ratio after angioplasty was observed, with a Z value of −2.051 and p < 0.04. In the secondary analysis, it was found that a Tp-e/QTc ≥ 0.29 post-angioplasty is a risk factor for presenting the following adverse events: in-hospital death (7.4 vs. 0%; p < 0.003), new ACS in 1-year follow-up (25.9 vs. 18.5%; p < 0.006), and reintervention in 1-year follow up (29.6 vs. 15%; p < 0.002).
Conclusions:
There is a significant shortening in the Tp-e/QTc ratio post-angioplasty in patients with ACS. This measure of TDR can serve as a predictor of in-hospital death, cardiovascular events and 1-year reintervention in patients with ACS treated initially by angioplasty.
Palabras llave : ACS; TDR; Tp-e; Tp-f/QT.