The Predictive Value Of Fragmented QRS Wave On Coronary Artery Lesions In Patients With Acute Myocardial Infarction(ami)

Background: Fragmented QRS wave(fQRS wave)presents significant predictive value for the mortality,cardiac insufficiency and ventricular aneurysm among patients with coronary heart disease.The pathologic Q wave after myocardial infarction may decay and even disappear over time.Therefore,fQRS wave becomes a promising supplementary index for the assessment of myocardial infarction.However,whether fQRS can be used as an independent index for the severity of coronary artery lesions still needs further exploration.Objective: To observe fQRS` predictive value for the severity of coronary artery disease in patients with acute myocardial infarctionMethod: A total of 697 patients who received primary percutaneous coronary intervention due to acute myocardial infarction(AMI)in the first affiliated hospital of Soochow University from May 2013 to July 2015,were collected.The general information,including essential laboratory data(such as fasting glucose,troponin,blood routine,hepatic and renal function),radiological data(including electrocardiogram)and past medical history were recorded.Then,the patients were divided into 3 groups according to the electrocardiogram(ECG,fQRS wave,pathologic Q wave,fQRS wave and pathologic Q wave)and coronary angiography results(Gensini score)after the revascularization.We compared the Gensini scores among groups with analysis of variance and obtained the variables of significance.Results: 1.A total of 278 patients presented fQRS wave or pathologic Q wave.The patients were divided into 3 groups,group A(fQRS group,76 subjects),group B(pathologic Q wave group,127 subjects)and group C(fQRS and pathologic Q wave group,75 subjects).control group D(unpresented fQRS wave or pathologic Q wave,74 subjects).Statistical analysis showed group A was different from group B and group C in mean age,troponin(cTn I)and creatine kinase isoenzyme(CK-MB)levels.There was no significant difference in mean age,cTn I or CK-MB levels between group A and group B.However,the incidence of hyperlipidemia was different between group A and group B.Compared with control group,the group A and group D,group B with Gensini score had significant difference between group D.Affects the Gensini score the highest group C,group A and group D Gensini score between group B and D group had significant difference.Group C affects the Gensini score the highest.2.Analyze the Gensini score between the groups found after continuous variables meet the requirements for the homogeneity of variance,and single factor variance analysis,it found that the effects of different wave on Gensini score have significant differences,through the multiple comparison can be obtained after the Gensini score the influence degree of the pathological Q wave is greater than the fQRS wave group;But both with group C(fQRS and pathologic Q wave),found in group C had the greatest influence on Gensini score.Conclusion: The fQRS wave may be a predictive factor of severe coronary artery disease.When FQRS and pathologic Q wave present at the same time,It reflects more severe coronary lesions...