Q-T. DISPERSION IN ACUTE MYOCARDIAL INFARCTION : EFFECT OF THROMBOLYTIC THERAPY
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This study was performed to assess Q-T dispersion in patients with acute myocardial infarction (AM)) treated with thrombolytic therapy versus conventional therapy. The study population included 50 patients: 25 were treated with streptokinase (SK) and the other 25 did not received such therapy due to contraindication. Their ages ranged between 37 to 80 years (mean 58.4 + 10.46). Thirty-six of them (72%) had anterior and 14 (28%) had inferior infarction. Twenty-five, age and sex-matched healthy subjects served as control group. Q-T dispersion and dispersion ratio were estimated thrice in 5K-treated group (on admission. 2hrs post- 5k and predischarge), twice in ,non-SK treated group (on admission and predischarge) and once for co) ols. Statistical analysis of the results showed that patients on admission had highly significant increase in g.T dispersion parameters compared to controls (p < 0.001). Subgroup analysis showed highly significant increase in g-T dispersion parameters in patients who were complicated compared to those who were not complicated with complex ventricular arrhythmias during hospital course (p <0.01). Also there was highly significant increase in these parameters in diabetic compared to nondiabetic patients (p < 0.01). Patients who were treated with SK showed highly significant decrease in dispersion parameters 2 hours after SK infusion and on discharge form hospital compared to that on admission (p < 0.01). Conversely. non-SK treated group showed highly significant increase in Q.T. dispersion on discharge from hospital compared to that on admission (p <0.01). In conclusion QT dispersion is increased after AMI and are higher in patients with ventricular arrhythrnias. Thrombolytir therapy is associated with marked reduction in g-T dispersion which may reduce the risk of electrical instability after AMI.