Relationship between presence of fragmented QRS on 12-lead electrocardiogram on admission and long-term mortality in patients with non-ST elevated myocardial infarction

Abstract

Presence of fQRS on a 12-lead ECG on admission is associated with increased long-term mortality in patients with NSTEMI.

Prognostic Value of QRS Fragmentation in Patients with Acute Myocardial Infarction: A Meta‐Analysis

“…10,12,14,[16][17][18] In four studies, the frequency of 3-vessel disease was higher in fQRS (+) group (ranged between 42% and 61%) compared to fQRS (-) group (ranged between 15% and 33%). In total, the frequency of 3-vessel disease was 46.4% in fQRS (+) group and was 24.2% in fQRS (-) group (P < 0.01).Whereas, two studies reported an insignificant difference between groups regarding multivessel involvement.…”

“…9, 14-18 Whereas, three studies reported an insignificant difference of left ventricular EF between the groups. [10][11][12] Seven studies reporting left ventricular EF in mean ± standard deviation were analyzed with the random effects approach. The overall effect showed that patients who had fQRS on admission ECG had a significantly lower LVEF than patients without fQRS (WMD −6.01, 95% CI [−9.08, −2.94], P < 0.00001) (Fig.…”

“…In total, the frequency of 3-vessel disease was 46.4% in fQRS (+) group and was 24.2% in fQRS (-) group (P < 0.01).Whereas, two studies reported an insignificant difference between groups regarding multivessel involvement. 12,17 Most of the patients with STEMI were treated with primary percutaneous coronary intervention (77.6%).…”

“…When only 3 NSTEMI studies are included in the analysis, mortality rate was higher in fQRS (+) group (17.7%) compared to fQRS (-) group (5.7%) (OR 3.42; 95% CI, 2.01-5.82; P < 0.00001). 10,12,17 When 2 studies which required persistence of fQRS(+) throughout the hospitalization period were excluded, 10, 14 presence of fQRS was still found to be correlated with higher risk of mortality in the remaining study population (OR 3.59; 95% CI, 1.99-6.47; P < 0.00001), in STEMI subgroup (OR 8.08; 95% CI, 2.65-24.65; P < 0.00001), 15,16,18 and in NSTEMI subgroup (OR 3.20; 95% CI, 1.46-6.99; P < 0.00001). 12, 17…”

“…[3][4][5][6][7] In addition, various studies have evaluated the prognostic importance of fQRS in patients with acute coronary syndrome (ACS), ST-segment elevation (STEMI), or non-ST segment elevation myocardial infarction (NSTEMI). [8][9][10][11][12][13][14][15][16][17][18] Some recent papers reviewed the clinical importance of fQRS in patients with cardiovascular diseases. [19][20][21] However, the literature regarding the definition and the prognostic value of fQRS in patients with AMI is heterogeneous and the findings are not easy to interpret.…”