Dal Evren, Eraybar Suna
Emercency Department, University of Health Sciences Bursa Faculty of Medicine Bursa Sehir Training and Research Hospital, Bursa, Turkey.
Sci Rep. 2025 Jul 12;15(1):25259. doi: 10.1038/s41598-025-11353-8.
To evaluate the prognostic value of the Tpe/QTc ratio on admission electrocardiograms in predicting major adverse cardiovascular events (MACE) in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous intervention. STEMI is closely associated with increased mortality and MACE, often indicated by electrocardiographic findings of repolarization abnormalities. These can reflect myocardial damage from ischemia and other pathological developments during patient follow-up. This study retrospectively analyzed patients presenting with characteristic symptoms of STEMI who underwent primary percutaneous coronary angiography. Tpe, QTc, and Tpe/QTc ratios were measured from admission ECGs and correlated with angiographic results, 90-day mortality rates, and MACE subcategories. The Tpe/QTc ratio predicts cerebral ischemic stroke and recurrent unstable angina within 90 days post-STEMI. Using a cutoff of 0.190 for the Tpe/QTc ratio, the method demonstrated a sensitivity of 83.3% and a specificity of 66.1% (AUC 0.743 ± 0.078). Additionally, a lower Tpe/QTc ratio was significantly associated with 90-day mortality, while a higher ratio was linked to recurrent unstable angina ( < 0.03). Variability in the Tpe interval and the Tpe/QTc ratio in acute STEMI cases provide critical prognostic information regarding patient outcomes and MACE risks. These insights can inform clinical decisions regarding follow-up and treatment strategies, including adjustments to anticoagulation and considerations for repeat angiography.
评估急性ST段抬高型心肌梗死（STEMI）患者接受直接经皮冠状动脉介入治疗时，入院心电图Tpe/QTc比值对预测主要不良心血管事件（MACE）的预后价值。STEMI与死亡率增加和MACE密切相关，常表现为复极异常的心电图表现。这些表现可反映患者随访期间缺血性心肌损伤和其他病理进展。本研究回顾性分析了出现STEMI特征性症状并接受直接经皮冠状动脉造影的患者。从入院心电图测量Tpe、QTc和Tpe/QTc比值，并将其与血管造影结果、90天死亡率和MACE亚类进行相关性分析。Tpe/QTc比值可预测STEMI后90天内的脑缺血性卒中和复发性不稳定型心绞痛。以Tpe/QTc比值0.190为临界值，该方法的敏感性为83.3%，特异性为66.1%（AUC 0.743±0.078）。此外，较低的Tpe/QTc比值与90天死亡率显著相关，而较高的比值与复发性不稳定型心绞痛相关（P<0.03）。急性STEMI病例中Tpe间期和Tpe/QTc比值的变异性提供了有关患者预后和MACE风险的关键预后信息。这些见解可为随访和治疗策略的临床决策提供参考，包括调整抗凝治疗和考虑重复血管造影。
