The predictive value of fragmented QRS for severe coronary stenosis in patients undergoing coronary CT angiography

BACKGROUND: Coronary artery disease (CAD) is the leading cause of death worldwide. Fragmented QRS (fQRS) has emerged as a new prognostic marker in cardiovascular disease. Coronary computed tomography angiography (CCTA) is an effective method to diagnose obstructive CAD. The degree of stenosis determines the severity of the disease. METHODS: A total of 120 patients admitted to the cardiology outpatient clinic with angina pectoris symptoms were included in the study. The fQRS is defined as the presence of an additional R wave, notching of the R wave, notching of the nadir of the S wave in 2 contiguous leads, or the presence of more than one R' wave without a typical bundle branch block. CCTA was performed on patients with low-moderate risk. The patients were divided into two groups based on the presence (Group 1, n = 58 patients) or the absence (Group 2, n = 62 patients) of ≥70 % coronary artery stenosis. RESULTS: The baseline characteristics of the patients were not significantly different. Group 1 had a higher prevalence of DM, hyperlipidemia, smoking, and fQRS compared to Group 2 (p < 0.05, for all). When the subjects were divided into two groups, fQRS (+) and fQRS (-), a statistically significant difference was revealed between the two groups (p < 0.001). A positive correlation was found between fQRS and ≥ 70 % stenosis in CCTA. In the multivariate regression analysis, smoking and fQRS were independent predictors of ≥70 % stenosis in CCTA. CONCLUSION: According to our study, fQRS, an important ECG finding, is associated with ≥70 % stenosis in CCTA and may be evaluated for the prediction of significant coronary stenosis.