Fragmented <scp>QRS</scp> and mortality in patients undergoing percutaneous intervention for <scp>ST</scp>‐elevation myocardial infarction: Systematic review and meta‐analysis

Kanjanahattakij, Napatt; Rattanawong, Pattara; Riangwiwat, Tanawan; Prasitlumkum, Narut; Limpruttidham, Nath; Chongsathidkiet, Pakawat; Vutthikraivit, Wasawat; Crossey, Erin

doi:10.1111/anec.12567

Cited by 16 publications

(10 citation statements)

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“…ST-elevation myocardial infarction (STEMI) is a leading life-threatening disease worldwide. 1 Although primary percutaneous coronary intervention has been approved as the gold standard therapy for patients with STEMI over the past 20 years, [2][3][4] patients with anterior wall STEMI have a worse prognosis than those with non-anterior wall STEMI. 5 Therefore, developing prognostic markers for patients with STEMI is essential to enable clinicians to develop risk stratifications for these patients.…”

Section: Introductionmentioning

confidence: 99%

Different associations between left atrial size and 2.5-year clinical outcomes in patients with anterior versus non-anterior wall ST-elevation myocardial infarction

et al. 2020

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Objective: To investigate associations between left atrial diameter (LAD) and long-term outcomes in patients with anterior or non-anterior wall ST-elevation myocardial infarction (STEMI). Methods: Patients with STEMI were included in this secondary analysis of data from a prospective cohort study in which the primary outcome was major adverse cardiovascular event (MACE) occurrence during a 2.5-year follow-up. A LAD cutoff value was obtained through receiver operating characteristic curve analysis. Kaplan-Meier curve and Cox regression analyses were applied. Subgroup Cox regression analysis was also performed, with patients stratified based on left ventricular diastolic diameter (LVEDD, > 55 mm and 55 mm). The relationship between LAD and outcomes in patients with anterior or non-anterior wall STEMI was explored using restricted cubic spline functions. Results: Out of 464 patients, adjusted Cox regression showed that dichotomous (>40 mm) LAD was significantly associated with MACE (hazard ratio 2.978, 95% confidence interval 1.763, 5.030) in patients with anterior wall but not non-anterior wall STEMI. The association was not different between normal and enlarged LVEDD groups. Conclusions: A left atrium > 40 mm may indicate higher risk of MACE in patients with anterior wall STEMI, even in patients with normal left ventricular structure. This relationship was not observed in patients with non-anterior wall STEMI.

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Section: Introductionmentioning

confidence: 99%

Different associations between left atrial size and 2.5-year clinical outcomes in patients with anterior versus non-anterior wall ST-elevation myocardial infarction

et al. 2020

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“…The presence of fQRS has been associated with increased risk of major arrhythmic events in patients with Brugada syndrome and hypertrophic cardiomyopathy (Rattanawong, Riangwiwat, Kanitsoraphan, et al, 2018;Rattanawong, Riangwiwat, Prasitlumkum, et al, 2018). Furthermore, the presence of fQRS has been associated with increased overall mortality in patients with ST-segment elevation myocardial infarction and pulmonary embolism (Kanjanahattakij et al, 2018;Qaddoura et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

The presence of fragmented QRS may predict the recurrence of nonvalvular atrial fibrillation after successful electrical cardioversion

Eren

Kaya

Öcal

et al. 2019

Noninvasive Electrocardiol

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Atrial fibrillation (AF), the most common cardiac rhythm disorder, affects approximately 2% of the general population and is associated with increased risk of stroke and mortality as well as reduced exercise capacity and quality of life (Camm et al., 2012; Kirchhof et al., 2007). Restoring normal sinus rhythm (NSR) improves symptoms and cardiac performance; however, a portion of these patients develop recurrent AF despite optimal medical treatment (Bertaglia et al., 2002). Several studies have evaluated clinical, electrocardiographic, and

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“…Связь fQRS с фиброзом миокарда была доказана в ряде исследований [22][23][24]. Продемонстрирована риск-стратификационная значимость этого ЭКГпризнака у пациентов с различной патологией сердечно-сосудистой системы при: ИБС [25][26][27][28][29], гипертрофической кардиомиопатии [30,31], синдроме Бругада [32], ХСН с нФВ ЛЖ [33]. Взаимосвязь между fQRS и систолической дисфункцией миокарда изучена меньше.…”

Section: Electrocardiographic Signs Of Impaired Depolarization (Fragm...unclassified

Electrocardiographic signs of impaired depolarization (fragmented QRS, early ventricular repolarization, etc.) as markers of left ventricular systolic dysfunction

et al. 2022

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Aim. To study the relationship between a decrease in left ventricular (LV) ejection fraction (EF) and conventional electrocardiographic (ECG) signs associated with myocardial structure changes (pathological Q wave, ventricular arrhythmias), and relatively novel and less studied (fragmented QRS (fQRS), early ventricular repolarization (EVR)) and to evaluate their significance for identifying patients with mildly-reduced EF (mrEF).Material and methods. The study included 148 patients who were treated and examined at the Almazov National Medical Research Center. During the ECG analysis, fQRS, EVR, pathological Q wave, and ventricular arrhythmias (VAs) were assessed. Echocardiography data were analyzed. Statistical processing was carried out, including Fisher and chi-squared test, as well as correlation and ROC analysis.Results. Depending on the EF level, patients were divided into three groups: group 1 — patients with reduced EF (rEF) (<40%); group 2 — patients with mrEF (40-49%); group 3 — patients with preserved EF (pEF) (>50%). In the 1st group (with rEF), fQRS was registered in 16 (51,6%) patients, in the 2nd (with mrEF) — in 13 (44,8%), in the 3rd (with EF >50%) — in 16 (18,2%). Pathological Q wave was detected in the 1st group (rEF) in 20 (65%) patients, in the 2nd (mrEF) — in 10 (35%); in the 3rd (pEF) — in 15 (18%) (p<0,001). ROC analysis found that fQRS is more important for identifying patients with mrEF. In the 1st group (rEF), EVR was registered in 2 (6,5%) patients, in the 2nd (pEF) — in 2 (6,9%), in the 3rd (EF>50%) — in 11 (12,5%); the differences were not significant (p=0,5). The relationship of EVR, the number of PVCs and the presence of ventricular tachycardia with EF was not revealed.Conclusion. FQRS is significantly more often observed with a decrease in EF and may be a marker of an mildly-reduced EF. There were no significant correlations between EVR and EF. There was also no relationship between VAs and LV systolic dysfunction.

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Fragmented QRS and mortality in patients undergoing percutaneous intervention for ST‐elevation myocardial infarction: Systematic review and meta‐analysis

Abstract: Fragmented QRS was associated with increased overall mortality up to threefold. Our study suggests that fQRS could be an important tool for risk assessment in STEMI patients who underwent PCI.

Cited by 16 publications

References 16 publications

Different associations between left atrial size and 2.5-year clinical outcomes in patients with anterior versus non-anterior wall ST-elevation myocardial infarction

Different associations between left atrial size and 2.5-year clinical outcomes in patients with anterior versus non-anterior wall ST-elevation myocardial infarction

The presence of fragmented QRS may predict the recurrence of nonvalvular atrial fibrillation after successful electrical cardioversion

Electrocardiographic signs of impaired depolarization (fragmented QRS, early ventricular repolarization, etc.) as markers of left ventricular systolic dysfunction

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