The Relationship Between Fragmented QRS Complex And Cardiac Events In Patients With Acute Myocardial Infarction

[Objective]To investigate the relationship between fragmented QRS complex(fQRS)and cardiac events in patients with acute myocardial infarction(AMI).[Methods]110 patients who was diagnosed as AMI and received percutaneous coronary intervention were studied.According to the presence of fQRS in the electrocardiagram,they were divided into fQRS group(group A),non-fQRS group(group B),fQRS at 2 leads group(group A1)and fQRS at >2 leads group(group A2).The relationships between fQRS and infarct sites,cardiac events which include severe arrhythmia(ventricular arrhythmia,atrial fibrillation and high atrioventricular block),cardiac death,cardiogenic shock and heart failure were analysed.Survival curve was plotted using the Kaplan-Meier method.Log-rank test was used to compare and analyze the survival rate of different groups.[Results](1)There was no significant difference in the location of fQRS between group A and group B,group A1 and group A2(P>0.05).(2)The incidences of heart failure,cardiogenic shock,ventricular arrhythmia,abnormality of C-reactive protein(CRP)and abnormality of brain natriuretic peptide(BNP)in group A were significantly higher than those in group B(P<0.05).The incidence of non-ST segment elevation myocardial infarction in group A was significantly lower than that in group B(P<0.05).There was no significant difference between the two groups in age,gender,family history,hyperlipidemia,diabetes history,hypertension history,smoking history,multivessel disease,cardiac death,high atrioventricular block and atrial fibrillation(P>0.05).(3)The incidence of multivessel disease,high atrioventricular block,abnormality of BNP and abnormality of CRP in group A2 were significantly higher than those in group A1(P<0.05).There was no significant difference in age,gender,family history,hyperlipidemia,diabetes history,history of hypertension,smoking history,NSTEMI,heart failure,cardiogenic shock,cardiac death,ventricular arrhythmia and atrial fibrillation between these two groups.(4)Employing the Kaplan-Meier method to analyze the cardiovascular death events in four groups during the follow-up period,the survival rate of group A decreased significantly comparing with group B(P<0.05).But there was no significantly difference between group A1 and group A2(P>0.05).[Conclusions]fQRS appearing in the patients with AMI is closely related to cardiac events such as severe arrhythmia.It also has predictive value for multivessdl disease,especially fQRS appearing >2 leads.AMI patients with fQRS can be regarded as high-risk groups who should give early intervention in order to reduce the mortality rate.