Iranian Heart Association Iranian Heart Journal 26 3 2025 07 01 Comparison of QT Dispersion Alterations and Left Ventricular Systolic Function in Acute ST-Elevation Myocardial Infarction Following Revascularization by Thrombolytic Therapy versus Primary PCI 27 40 223836 EN Yasser Ahmed Abd El Hady Department of Cardiology, Faculty of Medicine, Beni-Suef University, Egypt. Hesham Boshra Mahmoud Department of Cardiology, Faculty of Medicine, Beni-Suef University, Egypt. Mina Michael Mories Department of Cardiology, Sohag Health Insurance Hospital, Egypt. Osama Ahmed Amin Department of Cardiology, Faculty of Medicine, Beni-Suef University, Egypt. 0000-0001-5461-9720 Journal Article 2024 06 28 <strong><em>Background:</em></strong> Limited information exists regarding alterations in QT dispersion (QTd) in patients with acute ST-elevation myocardial infarction (STEMI) following thrombolytic therapy compared to primary percutaneous coronary intervention (PCI). Speckle-tracking echocardiography (STE) has emerged as a crucial prognostic tool in recent STEMI cases, allowing for the assessment of global and regional remodeling. We sought to analyze the changes in the QTd interval and global longitudinal strain (GLS) in STEMI patients after early reperfusion.   <strong><em>Methods:</em></strong> This study is a prospective observational analysis involving 100 STEMI patients. The participants were divided into 2 groups: Group I, consisting of 55 patients treated with primary PCI, and Group II, composed of 45 patients treated with thrombolytic therapy. A 12-lead surface ECG was performed upon admission and 48 hours post-revascularization to assess QTd changes in patients receiving thrombolytic therapy versus those undergoing primary PCI. GLS was evaluated using STE 72 hours after revascularization.   <strong><em>Results:</em></strong> No differences were observed between the 2 groups concerning baseline characteristics. A significant reduction in QTd occurred after revascularization in both groups, with a greater mean reduction noted in the primary PCI group. Patients in the primary PCI group exhibited significantly more negative GLS values than those in the thrombolytic group. Admission QTd and the percentage of QTd reduction were significant predictors of ventricular tachycardia.   <strong><em>Conclusions:</em></strong> This study underscores the potential of primary PCI to enhance patient outcomes in STEMI. The superior GLS results, reduced incidence of ventricular arrhythmias, and QTd reduction following revascularization in STEMI patients indicate that primary PCI could significantly transform patient care. <strong><em>(Iranian Heart Journal 2025; 26(3): 27-40)</em></strong> https://journal.iha.org.ir/article_223836_e8ac3ff5c63bb946bc912c16c1b83040.pdf