Prognostic value of fragmented QRS complexes in patients with acute anterior myocardial infarction treated with percutaneous coronary intervention

doi:10.3969/j.issn.1006-7795.2017.03.027

Abstract

Abstract: Objective To evaluate the prognostic value of fragmented QRS complexes in patients with acute anterior myocardial infarction treated with percutaneous coronary intervention.Methods A total of 213 patients with acute anterior myocardial infarction treated with percutaneous coronary intervention were included in this retrospective study. Patients were divided into 2 groups according to the presence or absence of fragmented QRS complex at discharge. Fragmented QRS complexes refer to various RSR' patterns (≥ 1 R' or notching of S wave or R wave) with or without Q wave in 2 or more contiguous leads corresponding to a major coronary artery territory on the routine 12-lead electrocardiograms (ECGs).Results The follow-up period was similar in both groups (P=0.319). During the 1-year follow-up, the incidence of major composite endpoint event was significant difference between the two groups in this study (P=0.001). The rate of all-cause death was 7.48% for the fragmented QRS complex group and 0.94% for the non-fragmented QRS complex group (P=0.019). Cardiac death rate was 5.61% in the fragmented QRS complex group and 0.94% in the non-fragmented QRS complex group(P=0.098). The incidence of acute coronary syndrome and coronary artery revascularization were similar between the two groups during 1-year follow-up. The incidence of heart failure was also similar between the two groups.Conclusion In patients with acute anterior myocardial infarction who underwent percutaneous coronary intervention, the incidence of major composite endpoint event was significantly higher in patients with fragmented QRS complex than those without fragmented QRS complex. The all-cause mortality rate was significantly increased in patients with fragmented QRS complex.

Key words: fragmented QRS complex, acute anterior myocardial infarction, percutaneous coronary intervention

CLC Number:

R542.2⁺2

Gao Dequan, Jia Wenfang, Xie Yachuang, Liu Mingtao, Dong Xinbo, Fang Xuehua, Li Xiaotao. Prognostic value of fragmented QRS complexes in patients with acute anterior myocardial infarction treated with percutaneous coronary intervention[J]. Journal of Capital Medical University, 2017, 38(3): 470-474.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2017.03.027

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2017/V38/I3/470

References

[1] Friedman P L, Fenoglio J J, Wit A L. Time course for reversal of electrophysiological and ultrastructural abnormalities in subendocardial Purkinje fibers surviving extensive myocardial infarction in dogs[J]. Circ Res, 1975, 36(1):127-144.
[2] Das M K, Saha C, El Masry H, et al. Fragmented QRS on a 12-lead ECG:a predictor of mortality and cardiac events in patients with coronary artery disease[J]. Heart Rhythm, 2007, 4(11):1385-1392.
[3] Das M K, Khan B, Jacob S, et al. Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease[J]. Circulation, 2006,113(21):2495-2501.
[4] Das M K, Zipes D P. Fragmented QRS:a predictor of mortality and sudden cardiac death[J]. Heart Rhythm,2009, 6:8-14.
[5] Flowers N C, Horan L G, Thomas J R, et al. The anatomic basis for highfrequency components in the electrocardiogram[J]. Circulation, 1969,39(4):531-539.
[6] Jain R, Singh R, Yamini S, et al. Fragmented ECG as a risk marker in cardiovascular diseases[J]. Curr Cardiol Rev, 2014, 10(3):277-286.
[7] Morita H, Kusano K F, Miura D, et al. Fragmented QRS as a marker of conduction abnormality and a predictor of prognosis of Brugada syndrome[J]. Circulation, 2008, 118(17):1697-1704.
[8] Das M K, Suradi H, Maskoun W, et al. Fragmented wide QRS on a 12-lead ECG:a sign of myocardial scar and poor prognosis[J]. CircArrhythmElectrophysiol, 2008, 1(4):258-268.
[9] Michael M A, El Masry H, Khan B R, et al. Electrocardiographic signs of remote myocardial infarction[J]. ProgCardiovasc Dis, 2007, 50(3):198-208.
[10] Guo R, Zhang J, Li Y, et al. Prognostic significance of fragmented QRS in patients with non-ST elevation myocardial infarction:results of a 1-year, singlecenter follow-up[J]. Herz, 2012,37(7):789-795.
[11] Akbarzadeh F, Pourafkari L, Ghaffari S, et al. Predictive value of the fragmented QRS complex in 6 month mortality and morbidity following acute coronary syndrome[J]. Int J Gen Med, 2013, 6:399-404.
[12] Pietrasik G, Goldenberg I, Zdzienicka J, et al. Prognostic significance of fragmented QRS complex for predicting the risk of recurrent cardiac events in patients with Q wave myocardial infarction[J]. Am J Cardiol, 2007, 100(4):583-586.
[13] Brenyo A, Pietrasik G, Barsheshet A, et al. QRS fragmentation and the risk of sudden cardiac death in MADIT Ⅱ. J Cardiovasc Electrophysiol, 2012; 23(12):1343-1348.
[14] Canga A, Kocaman S A, Durakoğlugil M E, et al. Relationship between fragmented QRS complexes and left ventricular systolic and diastolic functions[J]. Herz, 2013, 38(6):665-670.
[15] Ari H, Cetinkaya S, Ari S, et al. The prognostic significance of a fragmented QRS complex after primary percutaneous coronary intervention[J]. Heart Vessels, 2012, 27(1):20-28.
[16] Korhonen P, Husa T, Konttila T, et al. Fragmented QRS in prediction of cardiac deaths and heart failure hospitalizations after myocardial infarction[J]. Ann Noninvasive Electrocardiol, 2010, 15(2):130-137.
[17] Uslu N, Gul M, Cakmak H A, et al. The assessment of relationship between fragmented QRS complex and left ventricular wall motion score index in patients with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention[J]. Ann Noninvasive Electrocardiol, 2015, 20(2):148-157.
[18] Güngör B, Özcan K S, Karataş M B, et al. Prognostic value of QRS fragmentation in patients with acute myocardial infarction:a Meta-analysis[J]. Ann Noninvasive Electrocardiol, 2016, 21(6):604-612.