title: Fragmented QRS complexes have predictive value of imperfect ST-segment resolution in patients with STEMI after primary percutaneous coronary intervention.
abstract: OBJECTIVE
  To investigate the clinical characteristics of patients with the fragmented QRS complexes (fQRS) and the predictive value of fQRS in patients undergoing primary percutaneous coronary intervention (p-PCI).
  
  
  METHODS
  The study enrolled 227 consecutive patients with ST-elevation myocardial infarction who underwent p-PCI. Baseline clinical characteristics, the percentage of ST-segment resolution, and parameters of electrocardiography and coronary angiography were investigated. The relationship between fQRS on pre-PCI and post-PCI electrocardiogram and the percentage of ST-segment resolution after PCI were studied.
  
  
  RESULTS
  Patients with fQRS have higher troponin I, creatine kinase-MB levels, prolonged QRS duration, higher Gensini score, lower percentage of total ST-segment resolution, and left ventricular ejection fraction compared with patients without fQRS. Gensini score (odds ratio [OR], 1.013; 95% confidence interval [CI], 1.002-1.024; P < .006) and percentage of total ST-segment resolution (OR, 0.384; 95% CI, 0.186-0.795; P = .01) were independently associated with the presence of fQRS. A multivariate logistic regression analysis selected presence of fQRS pre-PCI (OR, 2.908; 95% CI, 1.095-7.723; P = .032) and the number of leads with fQRS before PCI (OR, 1.582; 95% CI, 1.250-2.002; P < .001) as independent predictors of imperfect ST-segment resolution.
  
  
  CONCLUSIONS
  The presence of fQRS is a predictor in ST-elevation myocardial infarction patients undergoing p-PCI. The occurrence of fQRS is beneficial to identify the patients with severe coronary lesion, left ventricular contraction dysfunction, and larger areas of ischemic injury.
authors.affiliation: Cardiovascular Institute, Second Hospital of Tianjin Medical University, Tianjin, China, 300211. Electronic address: MAXH@eyou.com.
authors.forename: Xianghong
authors.initials: X
authors.lastname: Ma
authors.affiliation: Cardiovascular Institute, Second Hospital of Tianjin Medical University, Tianjin, China, 300211. Electronic address: DUANWT@aliyun.com.
authors.forename: Wenting
authors.initials: W
authors.lastname: Duan
authors.affiliation: College of International Tianjin Medical University, Tianjin, China. Electronic address: PRODEEP@126.com.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Poudel
authors.affiliation: Cardiovascular Institute, Second Hospital of Tianjin Medical University, Tianjin, China, 300211. Electronic address: MAJW@126.com.
authors.forename: Junwei
authors.initials: J
authors.lastname: Ma
authors.affiliation: College of International Tianjin Medical University, Tianjin, China. Electronic address: DEEPARK@126.com.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Cardiovascular Institute, Second Hospital of Tianjin Medical University, Tianjin, China, 300211. Electronic address: xuyanminphd@aliyun.com.
authors.forename: Yanmin
authors.initials: Y
authors.lastname: Xu
mesh_terms: D015415:Biomarkers / Q000097:blood; D053840:Brugada Syndrome / Q000503:physiopathology*; D000075224:Cardiac Conduction System Disease; D015897:Comorbidity; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers