Fragmented QRS Complex as a Predictor of Multivessel Disease in Acute Coronary Syndrome

  • Idar Mappangara Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Hasanuddin—Dr.Wahidin Sudirohusodo General Hospital, Makassar
  • Abdul Hakim Alkatiri Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Hasanuddin—Dr.Wahidin Sudirohusodo General Hospital, Makassar
  • Stefan Hendyanto Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Hasanuddin—Dr.Wahidin Sudirohusodo General Hospital, Makassar
Keywords: fQRS, multivessel disease, ACS

Abstract

Background: The incidence of multivessel disease in acute coronary syndrome (ACS) is expected to be identified as early as possible in order to perform optimal management. The presence of multivessel disease can lead to ischemia or myocardial infarction. Fragmented QRS complex (fQRS) is a new electrocardiography (ECG) parameter that has been proven to be caused by ischemia or myocardial infarction.Methods: A cross-sectional study. Patients with ACS that admitted at Dr. Wahidin Sudirohusodo Makassar since December 2014 - March 2015 who are eligible were enrolled in this study.Presence of fQRS evaluated on first 12-lead ECG at hospital admission. Presence of multivessel disease based on coronary angiography. Data were analyzed by logistic regression. Data was significant if the p-value<0.05.Results: There are 63 subjects (56 men and 7 women) included in this study. Older age, history of ACS before, presence of dyslipidemia, and presence of fQRS were significantly more often in group with multivessel disease. After analyzed with logistic regression, the fQRS was the only significant predictor of multivessel disease with p value 0.003 and odds ratio 13.28.Conclusion: Presence of fQRS in the first 12-lead ECG when admitted to the hospital was an independent predictor of multivessel disease in patients with ACS.

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References

Goldstein JA, Demetriou D, Grines CL, et al. Multiple complex coronary plaques in patients with acute myocardial infarction. New England Journal of Medicine. 2000;343:915-922.

Sorajja P, Gersh BJ, Cox DA, et al. Impact of multivessel disease on reperfusion succes and clinical outcomes in patients undergoing primary PCI for AMI. European Heart Journal. 2007;28:1709-1716.

Asakura M, Ueda Y, Yamaguchi O, et al. Extensive development of vulnerable plaques as a pan-coronary process in patients with MI: an angioscopic study. Journal of the ACC. 2001;37:1284-1288.

Kato K, Yonetsu T, Kim SJ, et al. Nonculprit plaques in patients with ACS have more vulnerable features compared with those with non-ACS: a 3-vessel optical coherence tomography study. Circulation Cardiovascular Imaging. 2012;5:433-440.

Steger A, Sinnecker D, et al. Fragmented QRS: Relevance in clinical practice. Herzschrittmacherther Elektrophysiol. 2015;26:235-241.

Take Y, Morita H. Fragmented QRS: What Is The Meaning? Indian Pacing and Electrophysiology Journal. 2012;12:213-225.

Das MK, Khan B, et al. Significance of a fragmented QRS complex versus a Q wave in patients with CAD. Circulation. 2006;113:2495-2501.

Penalva RA, Huoya MdO, Correia LCL, et al. Lipid profile and severity of atherosclerotic disease in acute coronary syndrome. Arq Bras Cardiol. 2008;90(1):24-29.

Tanriverdi Z, Dursun H, Simsek MA, et al. The Predictive Value of Fragmented QRS and QRS Distortion for High-Risk Patients with STEMI and for the Reperfusion Success. Ann Noninvasive Electrocardiol. 2015.

Pietrasik G, Zarèba W. QRS fragmentation: Diagnostic and prognostic significance. Cardiol J. 2012;2:114-121.

Ari H, Cetinkaya S, Ari S, et al. The prognostic

significance of a fragmented QRS complex after primary PCI. Heart Vessels. 2011;27:20-28.

Michael MA, El Masry H, Khan BR, Das MK. Electrocardiographic signs of remote myocardial infarction. Prog Cardiovasc Dis. 2007;50:198–208.

Das MK, 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. Heart Rhythm. 2007;4:1385-1392.

Das MK, Michael MA, Suradi H, et al. Usefulness of fragmented QRS on a 12-lead electrocardiogram in acute coronary syndrome for predicting mortality. Am J Cardiol. 2009;104:1631-1637.

Bekler A, Barutcu A, Tenekecioglu E, et al. The relationship between fragmented QRS complexes and SYNTAX and Gensini scores in patients with acute coronary syndrome. Kardiol Pol. 2015;73(4):246-254.

Lee JW, Park HS, Ryu HM, et al. Impact of multivessel coronary disease with chronic total occlusionon one-year mortality in patients with acute myocardial infarction. Korean Circulation Journal. 2012;42(2):95-99.

Lekston A, Tajstra M, Gasior M, et al. Impact of multivessel coronary disease on 1?year clinical outcomes and 5?year mortality in patients with STEMI undergoing PCI. Kardiologia Polska. 2011;69,4:336–343.

Published
2017-04-18

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How to Cite
Mappangara, I., Alkatiri, A., & Hendyanto, S. (2017). Fragmented QRS Complex as a Predictor of Multivessel Disease in Acute Coronary Syndrome. Indonesian Journal of Cardiology, 37(3), 130-6. https://doi.org/10.30701/ijc.v37i3.576
Section
Clinical Research