Open AccessPredictive Value of a Fragmented QRS Complex in Patients Undergoing Primary Angioplasty for ST Elevation Myocardial Infarction
Author(s) -
Akgul Ozgur,
Uyarel Huseyin,
Pusuroglu Hamdi,
Surgit Ozgur,
Turen Selahattin,
Erturk Mehmet,
Ayhan Erkan,
Bulut Umit,
Baycan Omer Faruk,
Demir Ali Riza,
Uslu Nevzat
Publication year - 2015
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12179
Subject(s) - medicine , conventional pci , cardiology , percutaneous coronary intervention , myocardial infarction , hazard ratio , st segment , confidence interval , st elevation , electrocardiography , proportional hazards model , qrs complex
Objectives The aim of this study was to evaluate the prognostic value of fragmented QRS (fQRS) on electrocardiography (ECG) patients with acute ST‐segment elevation in myocardial infarction (STEMI), who are undergoing primary percutaneous coronary intervention (PCI). Methods We prospectively enrolled 414 consecutive STEMI patients (mean age of 55.2 ± 12.2 years old, range of 26–91‐years old) undergoing primary PCI. The study patients were divided into two groups according to the presence or absence of fQRS as shown by ECG in the first 48 hours. The presence of fQRS group was defined as fQRS(+) (n = 91), and the absence of fQRS group was defined as the fQRS(–) (n = 323) group. Clinical characteristics and the one‐year outcome of the primary PCI were analyzed. Results The patients in the fQRS(+) group were older (mean age 60.7 ± 12.5 vs. 53.6 ± 11.6 years old, P < 0.001). Higher one‐year all‐cause mortality rates were observed in the fQRS group upon ECG (23.1% vs. 2.5%, P < 0.001, respectively). When using the Cox multivariate analysis, the presence of fQRS on the ECG was found to be a powerful independent predictor of one‐year all‐cause mortality (hazard ratio: 5.24, 95% confidence interval: 1.43–19.2, P = 0.01). Conclusions These results suggest that the presence of fQRS on ECG was associated with an increased in‐hospital cardiovascular mortality, and one‐year all‐cause mortality in patients with STEMI who are under primary PCI.