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Research Article

JCDR. 2021; 12(5): 2132-2142


Electrocardiographic Changes Predicting Reperfusion of Acute ST Elevation Myocardial Infarction Treated with Primary Angioplasty

Eman Hesham Seddik, Mohammed Husam Aldin Alshaar, Abdullah Rajab Salim Aboubakr, Hanan Ibrahim Radwan.


Abstract

Background: Rapid reperfusion by PCI is the preferred treatment for STEMI. However, myocardial
tissue hypoperfusion persists after primary PCI in a substantial portion of patients despite restored
patency of the epicardial coronary circulation. The aim of the present study to assess the relationship
between both QRS duration, Tpe interval, corrected QT interval &Tpe/Qt ratio and reperfusion in
patients with ST-elevation myocardial infarction (STEMI) who were treated with a primary
percutaneous coronary intervention (PCI). Patients and methods: This cross sectional study was
conducted on 100 patients with acute STEMI managed by PPCI who admitted Cardiology Department,
Zagazig University Hospitals.All patients underwent medical history taking, clinical examination and
laboratory investigation included CBC, renal and liver functions, cardiac enzymes and electrolytes and
ECG were done to all patients before procedure and after primary PCI to assess changes.Result: Our
results included 100 cases showed that as the incidence of Post procedure no reflow detect by MBG
was 30.0%,longer QRS duration in no reflow group before and after PCI p value 0.001,0.005
repectively,longer pre and cTPE in no reflow0.03,0.001 respectively, multivariate regression
predictors of noreflow post PCI were pre QRS duration ≥86 age over sixty years old, diabetes mellitus
, smoking ,increase maximum ST elevation in mm.Conclusion: In STEMI patients undergoing
primary PCI, prolonged pre QRS duration ≥86 was associated with a low MBG, a sign of impaired
microvascular reperfusion in addission to age more than sixty years old, diabetes mellitus , smoking
,increase maximum ST elevation in mm were significant predicting variables for no reflow.

Key words: Percutaneous Coronary Intervention; MBG; QRS duration; TPE






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