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ST段抬高型心肌梗死患者校正QT间期延长与室性心律失常及院内死亡率的相关性:是神秘莫测还是清晰明了?

Correlation of Prolonged Corrected QT Interval With Ventricular Arrhythmias and In-Hospital Mortality Among ST-Elevation Myocardial Infarction Patients: A Mystique or Lucidity?

作者信息

Wattoo Muhammad Adnan, Tabassum Muhammad, Bhutta Kiran R, Kaneez Mehwish, Zaidi Syed Muhammad Jawad, Ijaz Hania, Awan Javeria, Irshad Umer, Azhar Muhammad Junaid, Rafi Zainab

机构信息

Cardiology, Sialkot Medical College, Sialkot, PAK.

Internal Medicine, Islam Medical College, Sialkot, PAK.

出版信息

Cureus. 2020 Dec 29;12(12):e12356. doi: 10.7759/cureus.12356.

Abstract

Background Ventricular arrhythmias (VAs) are a frequent cause of cardiovascular mortality, especially in developing countries. Prolongation of corrected QT (QTc) interval predisposes patients to life-threatening VAs. Our study aims to assess the correlation of prolonged QTc interval with VAs and in-hospital mortality among ST-elevation myocardial infarction (STEMI) patients.  Methods This cross-sectional study analyzed the data from 40 patients with a confirmed diagnosis of STEMI and prolonged QTc interval. The patients were evaluated for several characteristics including their electrocardiography (ECG) findings. The frequency of in-hospital mortality and VAs developed after admission were recorded. Spearman correlation was used to assess the correlation of prolonged QTc interval with VAs and in-hospital mortality. Results Out of 40 cases, 30 patients were males and 10 were females with a mean age hovering at 52.95 ± 10.65 years. The mean QTc interval of our patients was 512.02 ± 49.74 milliseconds (ms). A total of 11 (27.5%) patients developed VAs while 14 (35%) of the patients succumbed to the disease complications. Spearman correlation showed a strong significant positive correlation of QTc interval with VAs (rho = 0.658, p < 0.001) and in-hospital mortality (rho = 0.314, p = 0.04). Conclusion Prolonged QTc interval is positively correlated with VAs and in-hospital mortality among STEMI patients. These patients should be regularly monitored and must be managed with caution as they have increased chances to develop VAs and in-hospital mortality. There is an utmost need for curation of guidelines that aid in risk stratification and appropriate management of such patients.

摘要

背景

室性心律失常(VAs)是心血管疾病死亡的常见原因,尤其是在发展中国家。校正QT(QTc)间期延长使患者易发生危及生命的室性心律失常。我们的研究旨在评估ST段抬高型心肌梗死(STEMI)患者QTc间期延长与室性心律失常及院内死亡率之间的相关性。

方法

这项横断面研究分析了40例确诊为STEMI且QTc间期延长患者的数据。对患者进行了包括心电图(ECG)检查结果在内的多项特征评估。记录入院后发生的院内死亡率和室性心律失常的频率。采用Spearman相关性分析评估QTc间期延长与室性心律失常及院内死亡率之间的相关性。

结果

40例患者中,男性30例,女性10例,平均年龄为52.95±10.65岁。我们患者的平均QTc间期为512.02±49.74毫秒(ms)。共有11例(27.5%)患者发生室性心律失常,14例(35%)患者死于疾病并发症。Spearman相关性分析显示,QTc间期与室性心律失常(rho = 0.658,p < 0.001)及院内死亡率(rho = 0.314,p = 0.04)呈强显著正相关。

结论

STEMI患者QTc间期延长与室性心律失常及院内死亡率呈正相关。这些患者应定期监测,且必须谨慎处理,因为他们发生室性心律失常和院内死亡的几率增加。迫切需要制定有助于此类患者风险分层和适当管理的指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f225/7839800/57d709cce603/cureus-0012-00000012356-i01.jpg

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