title: Fragmented QRS on Admission Electrocardiography Predicts Long-Term Mortality in Patients with Non-ST-Segment Elevation Myocardial Infarction.
abstract: BACKGROUND
  Early diagnosis and identification of high-risk non-ST elevation myocardial infarction (NSTEMI) is an important issue. Fragmented QRS (fQRS) complexes are defined as various RSR' patterns on 12-lead resting electrocardiography (ECG). Previous studies revealed that fQRS is related with increased ventricular arrhythmias and cardiovascular mortality. The relation between fQRS and mortality in acute coronary syndromes, mitral valve disease severity and structural heart disease has been shown in different studies. The aim of this study was to investigate relation between fQRS and long-term cardiovascular mortality in NSTEMI patients.
  
  
  METHODS
  Patients who admitted to our emergency unit and diagnosed NSTEMI between 2012 and 2013, 433 patients were included prospectively. fQRS complexes determined in 85 patients. Patients were divided into two groups according to fQRS existence. All patients evaluated for their clinical, laboratory, electrocardiographic, and echocardiographic characteristics. Angiographic features of 315 patients who underwent coronary angiography was also recorded. In-hospital, 30-day and 12-month mortality was compared between these groups.
  
  
  RESULTS
  Demographic characteristics and cardiovascular risk factors were similar in both groups except hyperlipidemia. GRACE risk score was higher in patients with fQRS and positively correlated with existence of fQRS. In hospital and 30-days mortality were similar but late mortality was higher in fQRS group. Predictors of late mortality were found to be age, heart rate, male sex in addition to fQRS.
  
  
  CONCLUSIONS
  We found a relation between fQRS and late mortality. Fragmented QRS may be seen as a cautionary signal for extensive myocardial damage and thereby increased long-term mortality for patients with NSTEMI.
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Bozbeyoğlu
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Yıldırımtürk
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Yazıcı
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ufuk Sadık
authors.initials: US
authors.lastname: Ceylan
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Aysun
authors.initials: A
authors.lastname: Erdem
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kaya
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Cevdet
authors.initials: C
authors.lastname: Dönmez
authors.affiliation: Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Akyüz
authors.affiliation: Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Çetin
mesh_terms: D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072658:Non-ST Elevated Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors
keywords: fragmented QRS; mortality; non-ST elevation myocardial infarction