Archives of the
Turkish Society of Cardiology
Original Article - Coronary artery disease

Relationship between presence of fragmented QRS on 12-lead electrocardiogram on admission and long-term mortality in patients with non-ST elevated myocardial infarction


Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi, Kardiyoloji Ana Bilim Dalı, Çanakkale


Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı, Çanakkale


Bursa Yüksek İhtisas Eğitim Ve Araştırma Hastanesi, Kardiyoloji Kliniği, Bursa

Archives of the Turkish Society of Cardiology 2014; 42: 726-732
DOI: 10.5543/tkda.2014.79438
Read: 495 Downloads: 161 Published: 01 July 2021

Objectives: 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).

Study design: 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).

Conclusion: Presence of fQRS on a 12-lead ECG on admission is associated with increased long-term mortality in patients with NSTEMI.

ISSN 1016-5169 EISSN 1308-4488