Fragmented QRS (fQRS) Complex Predicts Adverse Cardiac Events of ST-Segment Elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention and Thrombolysis

Abstract

BackgroundST-segment elevation myocardial infarction (STEMI) is an acute and life-threatening disease. Adverse cardiac events (ACEs) are defined as cardiovascular death or worsening congestive heart failure in STEMI patients. The present study investigated the predictive role of fragmented QRS complex (fQRS) in risks of ACEs in STEMI.Material/MethodsThis study was a retrospective analysis involving patients who underwent percutaneous coronary intervention (PCI) or thrombolysis. STEMI patients were divided into the fQRS group (259 cases) and the non-fQRS group (161 cases). Basic information and clinical parameters were evaluated. ACEs, including hemodynamic instability, electrical instability (ventricular tachycardia event, ventricular fibrillation or atrioventricular heart-block) and death, were observed. The 12-lead ECG was used to obtain fQRS recordings. Thrombolytic recanalization was evaluated to confirm clinical outcomes of PCI and thrombolysis therapy.ResultsHemodynamic instability rates, electrical instability rates, and death in the fQRS group were significantly higher compared to the non-fQRS group (P=0.002, 0.000, and 0.010, respectively). PCI triggered significantly fewer ACEs compared to thrombolytic therapy in the fQRS group (P=0.000, 0.000, and 0.019, respectively). The fQRS group had higher thrombolysis failure rates and three-vessel lesion of coronary artery rates compared to the non-fQRS group (P=0.009 and 0.029, respectively). There were no differences between fQRS and non-fQRS groups in death rates of STEMI patients undergoing PCI and thrombolytic therapy. GRACE scores more than 140, EF less than 35%, and fQRS illustrated predictive potential for ACEs of STEMI patients.ConclusionsfQRS is an independent predictor for the adverse cardiac events of STEMI patients undergoing PCI or thrombolysis.

Predictive value of fragmented QRS for ventricular tachyarrhythmias in patients with acute myocardial infarction: A meta‐analysis

“…Then 241 studies were excluded based on title or abstract reading using the predefined eligibility criteria. From the remaining 12 studies that were reviewed in full text, three studies were not included because their endpoints were commingled with atrioventricular heart‐block or polymorphic ventricular extrasystoles, while another 2 were excluded because VTAs were not their observation endpoints. Unlike other studies investigating VTAs during AMI, the study by Lorgis et al investigated VTAs during long‐term follow‐up (846 ± 297 days) and was excluded for protecting our results against bias.…”

Predicting efficacy of combined assessment with fragmented QRS and severely depressed heart rate variability on outcome of patients with acute myocardial infarction

“…The presence of fQRS might indicate severe myocardial insult in AMI patients [3]. Previous studies demonstrated that fQRS was related to higher major adverse cardiovascular events (MACE) in patients with AMI [4][5][6][7][8]. Cardiac autonomic nerve function could be non-invasively assessed by heart rate variability (HRV) [9].…”