Research Article

Impact of fragmented QRS on in-hospital mortality in emergency coronary artery bypass grafting for STEMI: A retrospective analysis

Volume: 37 Number: 2 May 31, 2024
EN

Impact of fragmented QRS on in-hospital mortality in emergency coronary artery bypass grafting for STEMI: A retrospective analysis

Abstract

Objective: Fragmented QRS complex (fQRS) is associated with increased morbidity and mortality, sudden cardiac death, and recurrent cardiovascular events. The role of coronary artery bypass grafting (CABG) in the primary treatment of acute myocardial infarction remains controversial. In this study, we aimed to assess the predictive value of fQRS in-hospital mortality among acute segment elevation myocardial infarction (STEMI) patients undergoing emergency CABG for primary revascularization. Patients and Methods: Between 2010 and 2020, we retrospectively included 99 consecutive STEMI patients who were not eligible for primary percutaneous intervention and required emergency CABG. The study population was divided into two groups: survivors and non-survivors. We compared the two groups regarding demographic, clinical, and operative characteristics. Results: fQRS was identified as an independent predictor of in-hospital mortality (p = 0.037). Additionally, left ventricular ejection fraction (LVEF) was an independent predictor of in-hospital mortality (p = 0.028). Glomerular filtration rate (GFR), glucose levels, and Killip class ≥ III were significantly associated with in-hospital mortality (p = 0.002), (p = 0.001) and (p < 0.001). Conclusion: fQRS emerged as an independent predictor of in-hospital mortality among patients undergoing emergency CABG for primary revascularization in cases of STEMI.

Keywords

References

  1. Ibanez B, James S, Agewall S, et al.. ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018 7;39:119-77. doi: 10.1093/eurheartj/ehx393.
  2. Rohn V, Grus T, Belohlavek J, Horak J. Surgical revascularisation in the early phase of ST-segment elevation myocardial infarction: Haemodynamic status is more important than the timing of the operation. Heart Lung Circ 2017;26:1323-29. doi: 10.1016/j.hlc.2017.01.009.
  3. Khan AN, Sabbagh S, Ittaman S, et al. Outcome of early revascularization surgery in patients with ST-elevation myocardial infarction. J Interv Cardiol 2015;28:14-23. doi: 10.1111/joic.12177.
  4. Das MK, Saha C, El Masry H, et al. Fragmented QRS on a 12-lead ECG: a predictor of mortality and cardiac events in patients with coronary artery disease. Heart Rhythm 2007;4:1385-92. doi: 10.1016/j.hrthm.2007.06.024.
  5. Gungor B, Ozcan K S, Karatas M B, Sahin I, Ozturk R, Bolca O. (2016). Prognostic value of QRS fragmentation in patients with acute myocardial infarction: a meta-analysis. Ann Noninvasive Electrocardiol 2016;21:604-12. doi:10.1111/ anec.12357
  6. Rosengarten J A, Scott P A, Morgan J M. 2015). Fragmented QRS for the prediction of sudden cardiac death: a metaanalysis. Europace 2025; 17: 969-77. doi:10.1093/europace/ euu279
  7. Altunova M, Püşüroğlu H, Karakayalı M, et al. Relationship between fragmented QES complex and longterm cardiovascular outcome in patients with essential hypertension. Anatol J Cardiol. 2022;26:442-9. doi: 10.5152/ AnatolJCardiol.2022.1322.
  8. Kewcharoen J, Trongtorsak A, Kittipibul V, et al. Fragmented QRS predicts reperfusion failure and in-hospital mortality in ST-Elevation myocardial infarction: a systematic review and meta-analysis. Acta Cardiol 2020 ;75:298-311. doi: 10.1080/00015.385.2019.1584696.

Details

Primary Language

English

Subjects

Surgery (Other)

Journal Section

Research Article

Publication Date

May 31, 2024

Submission Date

December 18, 2023

Acceptance Date

February 23, 2024

Published in Issue

Year 2024 Volume: 37 Number: 2

APA
Altunova, M., & Cakmak, G. (2024). Impact of fragmented QRS on in-hospital mortality in emergency coronary artery bypass grafting for STEMI: A retrospective analysis. Marmara Medical Journal, 37(2), 121-128. https://doi.org/10.5472/marumj.1485355
AMA
1.Altunova M, Cakmak G. Impact of fragmented QRS on in-hospital mortality in emergency coronary artery bypass grafting for STEMI: A retrospective analysis. Marmara Med J. 2024;37(2):121-128. doi:10.5472/marumj.1485355
Chicago
Altunova, Mehmet, and Gul Cakmak. 2024. “Impact of Fragmented QRS on In-Hospital Mortality in Emergency Coronary Artery Bypass Grafting for STEMI: A Retrospective Analysis”. Marmara Medical Journal 37 (2): 121-28. https://doi.org/10.5472/marumj.1485355.
EndNote
Altunova M, Cakmak G (May 1, 2024) Impact of fragmented QRS on in-hospital mortality in emergency coronary artery bypass grafting for STEMI: A retrospective analysis. Marmara Medical Journal 37 2 121–128.
IEEE
[1]M. Altunova and G. Cakmak, “Impact of fragmented QRS on in-hospital mortality in emergency coronary artery bypass grafting for STEMI: A retrospective analysis”, Marmara Med J, vol. 37, no. 2, pp. 121–128, May 2024, doi: 10.5472/marumj.1485355.
ISNAD
Altunova, Mehmet - Cakmak, Gul. “Impact of Fragmented QRS on In-Hospital Mortality in Emergency Coronary Artery Bypass Grafting for STEMI: A Retrospective Analysis”. Marmara Medical Journal 37/2 (May 1, 2024): 121-128. https://doi.org/10.5472/marumj.1485355.
JAMA
1.Altunova M, Cakmak G. Impact of fragmented QRS on in-hospital mortality in emergency coronary artery bypass grafting for STEMI: A retrospective analysis. Marmara Med J. 2024;37:121–128.
MLA
Altunova, Mehmet, and Gul Cakmak. “Impact of Fragmented QRS on In-Hospital Mortality in Emergency Coronary Artery Bypass Grafting for STEMI: A Retrospective Analysis”. Marmara Medical Journal, vol. 37, no. 2, May 2024, pp. 121-8, doi:10.5472/marumj.1485355.
Vancouver
1.Mehmet Altunova, Gul Cakmak. Impact of fragmented QRS on in-hospital mortality in emergency coronary artery bypass grafting for STEMI: A retrospective analysis. Marmara Med J. 2024 May 1;37(2):121-8. doi:10.5472/marumj.1485355