title: Predictive value of a fragmented QRS complex in patients undergoing primary angioplasty for ST elevation myocardial infarction.
abstract: OBJECTIVE
  The aim of this study was to evaluate the prognostic value of fragmented QRS (fQRS) on electrocardiography (ECG) patients with acute ST-segment elevation in myocardial infarction (STEMI), who are undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  We prospectively enrolled 414 consecutive STEMI patients (mean age of 55.2 ± 12.2 years old, range of 26-91-years old) undergoing primary PCI. The study patients were divided into two groups according to the presence or absence of fQRS as shown by ECG in the first 48 hours. The presence of fQRS group was defined as fQRS(+) (n = 91), and the absence of fQRS group was defined as the fQRS(-) (n = 323) group. Clinical characteristics and the one-year outcome of the primary PCI were analyzed.
  
  
  RESULTS
  The patients in the fQRS(+) group were older (mean age 60.7 ± 12.5 vs. 53.6 ± 11.6 years old, P < 0.001). Higher one-year all-cause mortality rates were observed in the fQRS group upon ECG (23.1% vs. 2.5%, P < 0.001, respectively). When using the Cox multivariate analysis, the presence of fQRS on the ECG was found to be a powerful independent predictor of one-year all-cause mortality (hazard ratio: 5.24, 95% confidence interval: 1.43-19.2, P = 0.01).
  
  
  CONCLUSIONS
  These results suggest that the presence of fQRS on ECG was associated with an increased in-hospital cardiovascular mortality, and one-year all-cause mortality in patients with STEMI who are under primary PCI.
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Akgul
authors.affiliation: Department of Cardiology, School of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Hamdi
authors.initials: H
authors.lastname: Pusuroglu
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Surgit
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Selahattin
authors.initials: S
authors.lastname: Turen
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erturk
authors.affiliation: Department of Cardiology, School of Medicine, Balıkesir University, Balıkesir, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Ayhan
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Bulut
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Baycan
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Demir
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.
authors.forename: Nevzat
authors.initials: N
authors.lastname: Uslu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
keywords: ST elevation myocardial infarction; fQRS; primary angioplasty