PMID- 24892768
OWN - NLM
STAT- MEDLINE
DCOM- 20141218
LR  - 20211021
IS  - 1643-3750 (Electronic)
IS  - 1234-1010 (Print)
IS  - 1234-1010 (Linking)
VI  - 20
DP  - 2014 Jun 3
TI  - The relationship between fragmentation on electrocardiography and in-hospital 
      prognosis of patients with acute myocardial infarction.
PG  - 913-9
LID - 10.12659/MSM.890201 [doi]
AB  - BACKGROUND: In patients with acute ST elevation myocardial infarction (STEMI), 
      QRS fragmentation was determined as one of the indicators of mortality and 
      morbidity. The development of fragmented QRS (fQRS) is related to defects in the 
      ventricular conduction system and is linked to myocardial scar and fibrosis. 
      MATERIAL AND METHODS: We prospectively enrolled 355 consecutive patients 
      hospitalized in the coronary intensive care unit of our hospital with STEMI 
      between the years 2010 and 2012 and their electrocardiographic features and the 
      frequency of in-hospital cardiac events were evaluated. RESULTS: There were 217 
      cases in the fQRS group and 118 cases in the control group. QRS fragmentation was 
      found to be a predictor for major cardiac events. In the fragmented QRS group, 
      the frequency of in-hospital major cardiac events (MACE) and death were higher 
      (MACE p<0.001; death p<0.003). In the fragmented QRS group, the cardiac enzymes 
      (Troponin-I, CK-MB) were significantly higher than in the control group 
      (p<0.001). In subgroup analyses, apart from the presence of fragmentation, the 
      presence of more than 1 type of fragmentation and the number of fragmented 
      deviations were also found to be related with MACE. A significant negative 
      correlation was observed with the ejection fraction and, in particular, the 
      number of fragmented deviations. CONCLUSIONS: Fragmented QRS has emerged as a 
      practical and easily identifiable diagnostic tool for predicting in-hospital 
      cardiac events in acute coronary syndromes. Patients who present with a 
      fragmented QRS demonstrate increased rates of major cardiac events, death risk, 
      and low ejection fraction. In patients with STEMI, the presence of fQRS on the 
      ECG and number of fQRS derivations are a significant predictor of in-hospital 
      major cardiac events.
FAU - Yildirim, Ersin
AU  - Yildirim E
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
FAU - Karacimen, Denizhan
AU  - Karacimen D
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
FAU - Ozcan, Kazim Serhan
AU  - Ozcan KS
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
FAU - Osmonov, Damirbek
AU  - Osmonov D
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
FAU - Turkkan, Ceyhan
AU  - Turkkan C
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
FAU - Altay, Servet
AU  - Altay S
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
FAU - Ceylan, Ufuk Sadik
AU  - Ceylan US
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
FAU - Ugur, Murat
AU  - Ugur M
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
FAU - Bozbay, Mehmet
AU  - Bozbay M
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
FAU - Erdinler, Izzet
AU  - Erdinler I
AD  - Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery 
      Center, Istanbul, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20140603
PL  - United States
TA  - Med Sci Monit
JT  - Medical science monitor : international medical journal of experimental and 
      clinical research
JID - 9609063
SB  - IM
MH  - Coronary Angiography
MH  - *Electrocardiography
MH  - Female
MH  - *Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis/diagnostic imaging/*physiopathology/surgery
MH  - Prognosis
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Function, Left
PMC - PMC4052951
EDAT- 2014/06/04 06:00
MHDA- 2014/12/19 06:00
PMCR- 2014/06/03
CRDT- 2014/06/04 06:00
PHST- 2014/06/04 06:00 [entrez]
PHST- 2014/06/04 06:00 [pubmed]
PHST- 2014/12/19 06:00 [medline]
PHST- 2014/06/03 00:00 [pmc-release]
AID - 890201 [pii]
AID - 10.12659/MSM.890201 [doi]
PST - epublish
SO  - Med Sci Monit. 2014 Jun 3;20:913-9. doi: 10.12659/MSM.890201.