Predictive utility of the baseline Tp–e interval for early arrhythmic events in acute myocardial infarction: A cohort study

Objective: Acute myocardial infarction is a major cause of early cardiovascular morbidity and mortality, with arrhythmias contributing to adverse outcomes. This study evaluated the predictive utility of the baseline T wave peak–T wave end interval for arrhythmic events within 48 h in patients presenting with the first episode of acute myocardial infarction. Methods: In this analytical cohort study, 196 patients with acute myocardial infarction were enrolled. Clinical characteristics, electrocardiographic findings, echocardiographic findings, angiographic findings, arrhythmias, complications, and in-hospital mortality were recorded. Results: The mean age of the patients was 62.1 ± 10.3 years, and 69.4% were male. Arrhythmias occurred in 65.3% of patients, most commonly ventricular tachycardia (21.8%). Multivariable logistic regression identified higher Killip class (III–IV) and prolonged T wave peak–T wave end interval as the independent predictors of arrhythmias. A T wave peak–T wave end cutoff ≥98 ms showed a sensitivity of 77.3%, specificity of 52.9%, and diagnostic accuracy of 69%. The T wave peak–T wave end and T wave peak–T wave end/QT ratios were significantly higher among nonsurvivors, along with greater clinical severity. Conclusion: A prolonged baseline T wave peak–T wave end interval (≥98 ms) and higher Killip class independently predict early arrhythmias in acute myocardial infarction.