title: Prognostic Value of QRS Fragmentation in Patients with Acute Myocardial Infarction: A Meta-Analysis.
abstract: OBJECTIVE
  Fragmented QRS has emerged as a novel electrocardiographic parameter associated with adverse clinical events in various diseases. The aim of this study was to investigate the association of fQRS with in-hospital and long-term cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI).
  
  
  RESULTS
  We searched PubMed, Embase, Web of Science, and Cochrane Library up to October 2015 for eligible studies. We selected studies with fQRS defined with 12-lead ECG during the index hospitalization of STEMI/NSTEMI. Primary outcomes were in-hospital and long-term cardiovascular events. In-hospital mortality was significantly higher in fQRS (+) group (99/733; 13.5%) compared to fQRS (-) group (47/1293; 3.6%) (OR 4.03 95% CI 1.81-8.94; P = 0.0006). Long-term mortality rate was higher in fQRS (+) group (89/473; 18.8%) compared to fQRS (-) group (54/1009; 5.3%) (OR 3.93 95% CI 1.92-8.05; P = 0.0002). In addition the frequency of long-term MACE was higher in fQRS (+) group (46.9%) compared to fQRS (-) group (14.6%) (OR 5.13 95% CI 2.77-9.51; P < 0.00001) CONCLUSION: Presence of fQRS on admission ECG was found to be predictor of mortality, MACE, deterioration of LV function, and presence of multivessel disease in patients with STEMI and NSTEMI.
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Barış
authors.initials: B
authors.lastname: Güngör
authors.affiliation: Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey.
authors.forename: Kazım Serhan
authors.initials: KS
authors.lastname: Özcan
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey. karatasbaran@gmail.com.
authors.forename: Mehmet Baran
authors.initials: MB
authors.lastname: Karataş
authors.affiliation: Department of Cardiology, Bağcılar Training and Research Hospital, Istanbul, Turkey.
authors.forename: İrfan
authors.initials: İ
authors.lastname: Şahin
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Öztürk
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Bolca
mesh_terms: D004562:Electrocardiography; D017052:Hospital Mortality; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology*; D011379:Prognosis
keywords: coronary artery disease; fragmented QRS; myocardial infarction