The Difference on Features of Fragmented QRS Complex and Influences on Mortality in Patients with Acute Coronary Syndrome.

OBJECTIVES: To investigate whether the fragmented QRS (fQRS) complexes can be used to distinguish patients with early non-ST elevation myocardial infarction (NSTEMI) from those with unstable angina (UA). BACKGROUND: fQRS complex has been found to be linked to myocardial infarction and cardiac death. METHODS: The clinical data of 302 patients who had been diagnosed with coronary artery disease were retrospectively reviewed. Incidence of fQRS complex within 48 h of presentation was analyzed and patients with acute myocardial infarction (AMI) (n = 240) were followed up by telephone interviews for a mean of 61.47 (range, 59.60-63.35) months. RESULTS: Patients with NSTEMI exhibited higher incidence of fQRS than those with UA (p = 0.047). The incidence of fQRS in the inferior wall leads was significantly higher than that of other leads in patients with anterior wall infarction (p < 0.05). Kaplan-Meier analysis revealed a higher mortality rate in AMI patients with fQRS compared to non-fQRS patients (p = 0.001). CONCLUSIONS: Presence of fQRS complexes within 48 hours of presentation may be used to differentiate NSTEMI patients from UA patients. fQRS may also be used as a survival predictor for patients with AMI.