Document Type : Research Article
Abstract
Prediction of fatal arrhythmias in acute myocardial infarction (AMI) is extremely
important. Objective: Create a differential diagnostic model for predicting sudden
cardiac death in elderly patients with STEMI with the history of PCI. Methods: We
studied 152 patients (143 men and 9 women), mean age 70.3±3.4 years, with STEMI
after PCI; EF LV less than 50%. The patients were divided into 2 groups: those who
died on the first day from SCD and those who survived. The QT interval and its parts
were measured upon admission and after PCI. The control group consisted of 30
healthy individuals. Results: A model was developed for determining the level of risk of
arrhythmic death on the first day from SCD after successful PCI based on ECG criteria
using DA. The most informative for the differential diagnosis was a set of the following
indicators: QTd, QTapcd, and SubTd. The most significant indicator is Sub Td. The
following algorithms were developed: ROAD = Qtd x 0.3438 + QTapcd x 0.0842 -
SubTd x 0.0864 - 19.5068, NROAD = Qtd x 0.1997 - QTapcd x 0.0148 + SubTd x
0.3261 - 20.893. Their practical implementation on models is proved. Conclusion: The
creation of a “ROAD/NROAD” differential diagnosis model for predicting SCD in
patients with STEMI after PCI suggests practical application at the prehospital stage in
this category of patients for prophylactically fatal VA and SCD. Assessment of the
possible development of adverse events in patients with STEMI after PCI is possible
using the ECG method based on the use of indicators such as QTd, QTapcd, and
SubTd at the prehospital stage.
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