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Prediction of Reperfusion and Infarct Related Artery Patency after Thrombolysis in Acute Anterior Myocardial Infarction by Degree of P Wave Dispersion on ECG

2018; Volume: 10; Issue: 2 Linguagem: Inglês

10.3329/cardio.v10i2.36285

2309-6357

Md Monir Hossain Khan, Md Afzalur Rahman, Abdullah Al Shafi Majumder, Khondker Shaheed Hussain, Md. Toufiqur Rahman, Md Monsurul Haque, Mohammad Ullah, Mohammad Khalilur Rahman Siddiqui, Md Sariful Islam, Md Azijur Rahman,

ECG Monitoring and Analysis

Background: Early detection IRA patency following thrombolytic therapy is of great importance in terms of prognosis and identification of candidates for rescue percutaneous coronary intervention (PCI). P wave dispersion (PWD), a new parameter measured before and after thrombolytic therapy is supposed to predict successful reperfusion in patients with anterior acute myocardial infarction (AMI).Methods: 132 patients were selected and divided into two groups on the basis of ST Segment resolution (STR) after 120 minutes of thrombolysis. Group I: patients with STR >70%; Group II: patients with STR < 70%. P wave dispersion was measured in both groups before and after thrombolysis. All patients underwent coronary angiography (CAG). IRA was considered patent if TIMI flow grade was e”2.Results: It was observed that diabetes mellitus and dyslipidemia were significantly higher in group II patients (p=0.04 and p=0.03, respectively). PWD before thrombolysis (PWD0) and 90 minutes after thrombolysis (PWD90) in both groups were statistically insignificant (p=0.45 and p=0.19, respectively). The mean level of PWD120 was statistically significant (p=0.001). After multivariate regression analysis PWD120 was found to be the significant predictor of IRA patency (OR = 1.101; 95% CI = 1.012 – 1.240; p = 0.01).Conclusion: P wave dispersion in patients receiving thrombolytic therapy can be a predictor of successful reperfusion and patent IRA. PWD values, in combination with other reperfusion parameters, can contribute to the identification of rescue PCI candidates.Cardiovasc. j. 2018; 10(2): 158-163