PMID- 28746519
OWN - NLM
STAT- MEDLINE
DCOM- 20171124
LR  - 20200306
IS  - 1678-4170 (Electronic)
IS  - 0066-782X (Print)
IS  - 0066-782X (Linking)
VI  - 109
IP  - 3
DP  - 2017 Sep
TI  - Single Derivation Fragmented QRS Can Predict Poor Prognosis in Successfully 
      Revascularized Acute STEMI Patients.
PG  - 213-221
LID - S0066-782X2017005014101 [pii]
LID - 10.5935/abc.20170099 [doi]
AB  - BACKGROUND: QRS fragmentation (fQRS) is classically defined as the presence of 
      slurred QRS morphology in at least two contiguous leads, and its prognostic 
      importance has been shown in ST elevation myocardial infarction (STEMI). However, 
      no study has investigated the significance of single lead fQRS (sl-fQRS) in 
      surface electrocardiography (ECG). OBJECTIVES: To evaluate whether sl-fQRS is as 
      valuable as classical fQRS in patients with acute STEMI who had successful 
      revascularization with primary percutaneous coronary intervention (pPCI). 
      METHODS: We included 330 patients with a first STEMI who had been successfully 
      revascularized with pPCI. The patient's electrocardiography was obtained in the 
      first 48 hours, and the patients were divided into three groups according to the 
      absence of fQRS (no-fQRS); fQRS presence in a single lead (sl-fQRS); and >/=2 leads 
      with fQRS (classical fQRS). RESULTS: In-hospital mortality was significantly 
      higher both in patients with sl-fQRS and in patients with >/= 2 leads with fQRS 
      compared to patients with no-fQRS. In ROC curve analysis, >/= 1 leads with fQRS 
      yielded a sensitivity of 75% and specificity of 57.4% for the prediction of 
      in-hospital mortality. Multivariate analysis showed that sl-fQRS is an 
      independent predictor of in-hospital mortality (OR: 3.989, 95% CI: 1.237-12.869, 
      p = 0.021). CONCLUSIONS: Although the concept of at least two derivations is 
      mentioned for the classical definition of fQRS, our study showed that fQRS in 
      only one lead is also associated with poor outcomes. Therefore, >/=1 leads with 
      fQRS can be useful when describing the patients under high cardiac risk in acute 
      STEMI.
FAU - Tanriverdi, Zulkif
AU  - Tanriverdi Z
AD  - Balikligol State Hospital - Clinic of Cardiology, Turkey.
FAU - Dursun, Huseyin
AU  - Dursun H
AD  - Dokuz Eylul University - Faculty of Medicine - Department of Cardiology, Turkey.
FAU - Colluoglu, Tugce
AU  - Colluoglu T
AD  - Dokuz Eylul University - Faculty of Medicine - Department of Cardiology, Turkey.
FAU - Kaya, Dayimi
AU  - Kaya D
AD  - Dokuz Eylul University - Faculty of Medicine - Department of Cardiology, Turkey.
LA  - eng
LA  - por
PT  - Journal Article
DEP - 20170720
PL  - Brazil
TA  - Arq Bras Cardiol
JT  - Arquivos brasileiros de cardiologia
JID - 0421031
SB  - IM
MH  - Coronary Angiography
MH  - Electrocardiography
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention/*mortality
MH  - Prognosis
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/mortality/*surgery
PMC - PMC5586228
COIS- Potential Conflict of Interest No potential conflict of interest relevant to this 
      article was reported.
EDAT- 2017/07/27 06:00
MHDA- 2017/11/29 06:00
PMCR- 2017/09/01
CRDT- 2017/07/27 06:00
PHST- 2017/01/24 00:00 [received]
PHST- 2017/03/23 00:00 [accepted]
PHST- 2017/07/27 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2017/07/27 06:00 [entrez]
PHST- 2017/09/01 00:00 [pmc-release]
AID - S0066-782X2017005014101 [pii]
AID - 10.5935/abc.20170099 [doi]
PST - ppublish
SO  - Arq Bras Cardiol. 2017 Sep;109(3):213-221. doi: 10.5935/abc.20170099. Epub 2017 
      Jul 20.