The Predictive Value Of Fragmented QRS Complex Of Acute Anterior Wall Myocardial Infarction In The Acute Phase

Objectives:Coronary artery disease(CAD) is considerated as a leading cause of morbidity and mortality in most of countries of the whole world. [3]That makes the risk stratification quite important to prevent and manage. Our study was to evaluate the prognostic value of fragmented QRS(f QRS) of patients with acute ST-segment elevation myocardial infarction(STEMI) in anterior wall. Methods:738 consecutive STEMI patients suffered acute ST-segment elevation myocardial infarction(STEMI) in anterior wall during 2006 to 2013 who were admitted into our center retrospectively were enrolled in our study. These patients were divided into two groups, f QRS(+)(n=435) and f QRS(-)(n=303), according to the presence or absence of f QRS in the ECG they took as they arrived the emergency room. Clinical characteristics and the in-hospital outcome of the reperfusion therapy were analyzed. Results:The presence of fragmented QRS complex is associated with age, genda, and myocardial zymetology. The patients in the f QRS(+) group were older(mean age 64.0 ± 12.2 vs. 62.3 ± 13.1 years old, P < 0.001). Both before and after any refussion therapy and Secondary prevention therapy of coronary heart disease treatment, the incidence rate of Major Adverse Cardiovascular Events(MACE) is significantly higher in f QRS(+) group rather than the f QRS(-) group, are 16.1% and 6.6% respectively. Furthermore, after the therapies, part of the patients in f QRS(+) group lost their f QRS complex, but these patients didn’t show a lower incident rate of Major Adverse Cardiovascular Events than those whose fragmented QRS complex persisited. Conclusion:These results suggest that the presence of f QRS was associated with an increased in-hospital cardiovascular mortality. Once there was a fragmented QRS complex, whether vary as the therapy, the Major Adverse Cardiovascular Events(MACE) of these patients happened more than those who showed a negative presence of fragmented QRS complex. Therefore, patients of acute Coronary artery disease with a fragmented QRS complex are much more in need of close guardianship and actively treatment.