Microvolt T-wave alternans in young myocardial infarction patients with preserved cardiac function treated with single-vessel primary percutaneous coronary intervention
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Submission date: 2016-06-25
Acceptance date: 2016-07-13
Publication date: 2016-07-27
Arch Med Sci Atheroscler Dis 2016;1(1):68-74
Introduction: Myocardial infarction continues to be the most important cause of morbidity and mortality, and recently this disease has begun to be seen uncommonly at young ages. In our study we aimed to assess microvolt T-wave alternans in young patients who had ST segment elevation myocardial infarction with preserved left ventricular function and who underwent single-vessel revascularization.
Material and methods: We enrolled 108 consecutive patients (age: 39.5 ±4.1) with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention and 43 patients (age: 38.5 ±3.7) with normal coronary angiograms as a control group. The myocardial infarction patients were younger than 45 and had a preserved left ventricular ejection fraction. They were divided into three groups according to the culprit artery. The microvolt T-wave alternans (MTWA) values were calculated an average of 12 months after the primary percutaneous coronary intervention using the modified moving average method.
Results: The MTWA positivity was significantly higher in the STEMI group compared to the controls (p < 0.001). It was also significantly higher in STEMI patients with left anterior descending artery lesions compared to patients with circumflex artery and right coronary artery lesions (p = 0.013). Moreover, the culprit artery was an independent predictor of MTWA positivity (p = 0.043).
Conclusions: In STEMI patients of a young age, MTWA positivity was higher than in healthy individuals, especially when the responsible vessel fed a wider region.
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