| Background and objectives Fragmented QRS(f QRS) complexes on rutine 12-lead electrocardiography(ECG) have been reported to be predictors of cardiac events and all-cause mortality in coronary artery disease(CAD). In this study, acrroding to the presence of f QRS by the body surface electrocardiography in patients with actue coronary disease to invstigate the relationship between fragmented QRS complexes and coronary atery lesion in patients with acute coronary syndrome(ACS).Methods The study was conducted in department of cardiology at the Third Affiliated Hospital of Anhui Medical University in Hefei,China. A total of two-hundred and four eligible patients with ACS(81 ST elevated myocardial infarction [STEMI],123 non-ST elevated acute coronary syndrome [NSTE-ACS]) were evaluated retrospectively in this study. All patients by f QRS were divided into two group: the fragmented QRS and the non-fragmented QRS. Two groups were compared the clinic data, including: Age, sex, hypertension, diabetes, smoking, TC, LDL, Cys C, creatinine, WBC, hemoglobin,RDW-CV, the types of ACS, the Gensini score, lesion blood vessel number. Analysis the correlation between Gensini scores and Cys C, WBC, RDW-CV levels using spearman correlation analysis. Analyzed the presence of f QRS related factors by Logistic regression analysis. To evaluated the relationship between the numbers lead of f QRS and Gensini scores by using spearman correlation analysis.Results(1) In the analysis of the study groups, age, Cys C levels, WBC levels and RDW-CV levels were significantly higher in the f QRS group(p<0.05). There is not statistically significant in two groups among sex, diabetes mellitus, the hypertension, smoking, LDL,TC, Cr,Hb(p<0.05).(2) Spearman correlation analysis showed Gensini score and Cys C levels, WBC levels, RDW-CVlevels were positively correlated(respectively, r=0.24, r=0.36, r=0.293, p<0.01).(3) In the f QRS group, the patients with STEMI were more than NSTE-ACS(66.2% VS 33.8%),but in the non-f QRS group, the patients with STEMI were lower than NSTE-ACS(24.6% VS 75.4%).(4) Patients with STEMI were of a higher Gensini score in comparison to patients with NSTE-ACS(,p<0.001).(5) In the f QRS group, there is statistically significant higher of Gensini score than the non- f QRS group(p<0.01).(6) The group of f QRS was respectively 27(36.5%),19(25.7%) and 28(37.8%) in the number of single-vessel disease, double-vessel disease and multiple-vessel disease,but the group of non-f QRS was respectively 55(42.3%),50(38.5%) and 25(19.2%).(7) With binary logistic multivariable regression analysis to Gensini score was independent predictor the presence of f QRS(OR=1.176,95%CI:1.065~1.299,p=0.001).(8) Spearman correlation analysis showed Gensini score and the number lead of f QRS was positively correlated(r=0.586,P <0.001).Conclusion(1) Not only Gensini score was independent predictor the presence of f QRS,but also Gensini score and the number lead of f QRS was positively correlated,therefore, f QRS could be used as a noninvasive indicator of the range and severity of coronary artery lesions. |
