The Role of T Peak – T End Interval Reduction on Electrocardiogram as a Marker of Successful Reperfusion in Patients with ST Elevation Myocardial Infarction undergoing Fibrinolytic Therapy

Background: Immediate reperfusion is the key of ST Elevation Myocardial Infarction (STEMI) Management. Despite the superiority of primary percutaneous coronary intervention (PCI), fibrinolytic therapy is still the preferred choice in many settings because of their availability and easy resources. Assessment of successful fibrinolytic determines the next strategy, ST-segment resolution (STR) correlates well with TIMI flow, reflects myocardial perfusion, and has a better prognostic value. T Peak – T End (Tpe) interval is proposed to be a valuable tool for reperfusion marker as it measures the transmural dispersion of repolarization (TDR) which can be an additional myocardial perfusion assessment. This study aims to see whether the Tpe interval reduction can be a marker of the successful reperfusion in patients with STEMI treated with fibrinolytic.   Methods : This cross-sectional study involved STEMI patients underwent fibrinolytic therapy. Tpe interval was measured at admission and 90 minutes after fibrinolytic, then the changes in the form of difference (ms) and resolution (%) were assessed and compared between successful and failed reperfusion groups according to STR. Results: Among total of 86 patients, there were 53 patients (61.2%) with successful reperfusion. Tpe interval reduction was greater in the successful reperfusion group. The value of Tpe difference in predicting STR ³ 50% had a sensitivity of 66% and specificity of 75.8% with an area under curve (AUC) of 0.726 and a cut-off point of 20 ms. While the AUC of Tpe resolution 0.726 with a cut-off point of 16.2%, had a sensitivity of 66% and a specificity of 72.7%. Conclusion: The Tpe interval reduction can be a valuable additional marker of successful reperfusion in patients with STEMI treated with fibrinolytic.