PMID- 22864316
OWN - NLM
STAT- MEDLINE
DCOM- 20140109
LR  - 20220316
IS  - 1016-5169 (Print)
IS  - 1016-5169 (Linking)
VI  - 40
IP  - 3
DP  - 2012 Apr
TI  - The importance of fragmented QRS complexes in prediction of myocardial infarction 
      and reperfusion parameters in patients undergoing primary percutaneous coronary 
      intervention.
PG  - 213-22
LID - 10.5543/tkda.2012.36937 [doi]
AB  - OBJECTIVES: The QRS complex fragmentations (fQRS) frequently seen on admission 
      electrocardiograms (ECGs) with narrow or wide QRS complex are associated with 
      increased morbidity and mortality. The causative relationship between fQRS and 
      cardiac fibrosis is known, but the relation of fragmented QRS before and after 
      primary percutaneous coronary intervention (p-PCI) with myocardial infarction and 
      reperfusion parameters has not been studied until now. STUDY DESIGN: The study 
      included 184 consecutive patients with ST elevation myocardial infarction (STEMI) 
      who underwent p-PCI. Presence or absence of fQRS on pre- and post-PCI ECGs and 
      its change following PCI were investigated. In addition, independent predictors 
      of fQRS were also investigated. Patients with significant organic valve disease 
      and patients having any QRS morphology with QRS duration ?120 ms as well as 
      patients with permanent pacemakers were excluded from the study. RESULTS: 
      Patients with fQRS on admission ECG had higher leukocyte counts (p=0.001), higher 
      CK-MB (p=0.001) and troponin levels (p=0.005), increased pain to balloon time 
      (p=0.004), higher Killip score (p<0.001), prolonged QRS time (p<0.001), higher 
      Gensini score (p<0.001) and more frequent Q waves on ECG (p<0.001) in comparison 
      to patients with non-fragmented QRS. In addition, these patients usually had an 
      infarction of anterior territory related to a lesion in proximal LAD and wider 
      jeopardized myocardium (p<0.001). fQRS was significantly related to infarction 
      and myocardial reperfusion parameters before and after p-PCI. In the setting of 
      STEMI, absence of fQRS on admission ECG predicted increased ST resolution, higher 
      reduction in QRS duration, and better myocardial reperfusion. CONCLUSION: FQRS 
      may be useful in identifying patients at higher cardiac risk with larger areas of 
      ischemic jeopardized or necrotic myocardium.
FAU - Kocaman, Sinan Altan
AU  - Kocaman SA
AD  - Department Of Cardiology, Rize Education And Research Hospital, Rize, Turkey. 
      sinanaltan@gmail.com
FAU - Cetin, Mustafa
AU  - Cetin M
FAU - Kiris, Tuncay
AU  - Kiris T
FAU - Erdogan, Turan
AU  - Erdogan T
FAU - Canga, Aytun
AU  - Canga A
FAU - Durakoglugil, Emre
AU  - Durakoglugil E
FAU - Satiroglu, Omer
AU  - Satiroglu O
FAU - Sahinarslan, Asife
AU  - Sahinarslan A
FAU - Cicek, Yuksel
AU  - Cicek Y
FAU - Sahin, Ismail
AU  - Sahin I
FAU - Bostan, Mehmet
AU  - Bostan M
LA  - eng
PT  - Journal Article
PL  - Turkey
TA  - Turk Kardiyol Dern Ars
JT  - Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir
JID - 9426239
RN  - 0 (Troponin I)
RN  - EC 2.7.3.2 (Creatine Kinase, MB Form)
SB  - IM
MH  - Aged
MH  - Creatine Kinase, MB Form/blood
MH  - *Electrocardiography
MH  - Female
MH  - Humans
MH  - Leukocyte Count
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis/physiopathology/therapy
MH  - Myocardial Reperfusion Injury/*diagnosis/physiopathology/therapy
MH  - *Percutaneous Coronary Intervention
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Stents
MH  - Troponin I/blood
EDAT- 2012/08/07 06:00
MHDA- 2014/01/10 06:00
CRDT- 2012/08/07 06:00
PHST- 2012/08/07 06:00 [entrez]
PHST- 2012/08/07 06:00 [pubmed]
PHST- 2014/01/10 06:00 [medline]
AID - 10.5543/tkda.2012.36937 [doi]
PST - ppublish
SO  - Turk Kardiyol Dern Ars. 2012 Apr;40(3):213-22. doi: 10.5543/tkda.2012.36937.