Prognostic significance of fragmented QRS in patients with non-ST elevation myocardial infarction

Objectives

The aim of this study was to evaluate the predictive value of fragmented QRS (fQRS) among non-ST elevation acute coronary syndrome (ACS) patients.

Design

The fQRS on standard 12-lead ECGs in 179?patients (63% males, mean age 60.9?±?12.3?years) were analyzed. Cardiac events and cardiac mortality were regarded as two outcomes to determine whether fQRS was a clinical prognostic factor; its prognostic value was then assessed adjusting for other covariates.

Results

Cardiac mortality (18 (17.0%) vs. 4 (5.5%)) and major cardiac event rate (46 (43.4%) vs. 22 (30.1%)) were higher in the fQRS group compared with the non-fQRS group during a mean follow-up of 12?months. A Kaplan–Meier survival analysis revealed significantly lower event-free survival for cardiac events (p?=?0.030) and cardiac mortality (p?=?0.020). Multivariate Cox regression analysis revealed that significant fQRS was an independent significant predictor for cardiac events and cardiac mortality.

Conclusion

These results indicate that the occurrence of fQRS in the ECG is a powerful predictor of decreased survival in NSTEMI. The prognostic importance of fQRS was incremental to clinical and conventional factors.