Key result
Fragmented QRS loses independent association with cardiovascular mortality after multivariable adjustment.
Why the study?
Fragmented QRS on ECG has been identified as a possible marker of myocardial conduction abnormalities, but its association with incident cardiovascular diseases and mortality needed investigation in a population-based cohort.
Does the presence of fragmented QRS on ECG predict the incidence of cardiovascular diseases and CVD-related mortality in a general population without prior CVD?
Cohort (n=8,834)
Does the presence of fragmented QRS on ECG predict the incidence of cardiovascular diseases and CVD-related mortality in a general population without prior CVD?
Hazard Ratio: 2.533 (95% CI 1.12–5.73)
Absolute Event Rate: 4.1% vs 1.7%
p-value: p=0.026
While fragmented QRS is associated with higher cardiovascular mortality in unadjusted analyses, it does not remain an independent predictor after adjusting for baseline cardiovascular risk factors in a general population.
fQRS is not independently associated with CVD mortality after adjustment; leaves open its added prognostic value in primary prevention.
Fragmented QRS (fQRS) on electrocardiography (ECG) has been identified as a possible marker of myocardial conduction abnormalities and adverse cardiovascular events. In this cohort study, we investigated the presence of fQRS and its association with the incidence of cardiovascular diseases (CVDs) and CVD-related mortality in participants of the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study. A total of 8,834 individuals with interpretable baseline ECGs and without confirmed CVD were included and classified into the fQRS group ( n = 146, 1.7%) and the non‑fQRS group ( n = 8,688, 98.3%). During a 10‑year follow‑up period, CVD developed in 18 (12.3%) individuals in the fQRS group and 924 (10.7%) in the non‑fQRS group. CVD‑related mortality occurred in 6 (4.1%) individuals with fQRS and 149 (1.7%) individuals without fQRS. Unadjusted and partially adjusted Cox regression analyses demonstrated an association between the presence of fQRS and increased risk of CVD mortality (HR: 2.533, 95% CI: 1.120–5.730, p = 0.026) and coronary artery disease (CAD) mortality (HR: 2.852, 95% CI: 1.164–6.990, p = 0.022). However, this association was attenuated after adjustment for all baseline variables. Kaplan-Meier survival analysis demonstrated lower survival probability among individuals with fQRS. These findings suggest that the presence of fQRS may be associated with increased cardiovascular mortality, particularly in patients who develop CAD, although its independent predictive value requires further investigation.
No takes yet. Share an insight, caveat, or question.
Gholamalizadeh et al. (2026) conducted a cohort in Cardiovascular diseases (n=8,834). Fragmented QRS (fQRS) vs. Non-fragmented QRS (non-fQRS) was evaluated on CVD-related mortality (HR 2.533, 95% CI 1.120-5.730, p=0.026). Fragmented QRS on baseline ECG was associated with increased cardiovascular mortality (HR 2.533), but this association was attenuated and no longer significant after adjusting for baseline variables.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: