title: [Relationship between presence of fragmented QRS on 12-lead electrocardiogram on admission and long-term mortality in patients with non-ST elevated myocardial infarction].
abstract: OBJECTIVE
  Fragmented QRS (fQRS) as a predictor of cardiac events in coronary artery disease has previously been reported. In this study, we hypothesized that presence of fQRS on a 12-lead electrocardiogram (ECG) on admission would be predictive of adverse outcomes in non-ST elevated myocardial infarction (NSTEMI).
  
  
  METHODS
  A total of 149 NSTEMI patients (112 male, 37 female) were retrospectively analyzed. The fQRS pattern was defined as the presence of an additional R', notching in the nadir of the S wave, fragmentation of the RS or QS complexes in 2 contiguous leads corresponding to a major coronary artery territory. The relationship between presence of fQRS on admission on a 12-lead ECG, and primary end points [cardiovascular death (CVD)] and secondary end points (re-infarction, repeat target vessel revascularization [percutaneous/surgical]) were assessed. The median follow-up time was 18 (13-24) months.
  
  
  RESULTS
  Other than age, there were no significant differences in baseline characteristics and laboratory findings for patients in the fQRS and non-fQRS groups. The patients in the fQRS group were older [64 years vs 59 years, p=0.048]. CVD and re-infarction were significantly higher in the fQRS group in the median 18-month follow-up (26.1% vs 8.7%, p=0.005; 23.9% vs 10.7%, p=0.035, respectively). By a multivariate regression analysis in all 149 patients, age ≥65 years and the presence of fQRS in a 12-lead ECG on admission were found to be powerful independent predictors of cardiovascular mortality (HR: 4.91, 95% CI: 1.60-15.03, p=0.005; HR: 2.77, 95% CI: 1.02-7.50, p=0.044, respectively).
  
  
  CONCLUSIONS
  Presence of fQRS on a 12-lead ECG on admission is associated with increased long-term mortality in patients with NSTEMI.
authors.affiliation: Department of Cardiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey. adembekler27@gmail.com.
authors.forename: Adem
authors.initials: A
authors.lastname: Bekler
authors.affiliation: Department of Cardiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Gazi
authors.affiliation: Department of Internal Medicine, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Erbağ
authors.affiliation: Department of Cardiology, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa.
authors.forename: Tezcan
authors.initials: T
authors.lastname: Peker
authors.affiliation: Department of Cardiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Barutçu
authors.affiliation: Department of Cardiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Altun
authors.affiliation: Department of Cardiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Temiz
authors.affiliation: Department of Cardiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yılmaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D010343:Patient Admission; D011237:Predictive Value of Tests; D014421:Turkey / Q000453:epidemiology