Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome

Hanan Ibrahim Radwan; Kamal Saad Mansour; Mohammed Mustafa Al-Daydamony; Reema Saed Mohammed

doi:doi:10.11648/j.ccr.20190303.16

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Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome

Hanan Ibrahim Radwan, Kamal Saad Mansour, Mohammed Mustafa Al-Daydamony, Reema Saed Mohammed

Published in Cardiology and Cardiovascular Research (Volume 3, Issue 3)

Received: 17 August 2019 Accepted: 4 September 2019 Published: 23 September 2019

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Abstract

Background: To detect the potential in hospital prognostic value of fQRS complex in patients with acute coronary syndrome (ACS) & investigate whether FQRS complex can be used to distinguish patients with early NSTEMI from those with unstable angina. Methods: It included 150 patients with acute NSTEMI and unstable angina. All patients were subjected to Grace score calculation, ECG to detect ischemic changes and detect presence or absent of fQRS, transthoracic echo to detect LV ejection fraction and recording in-hospital outcome. Results: Patients with fQRS have significant higher Killip class>2, higher troponin &CKMB levels, higher grace score, increased LVEDD & LVESD and significantly lower LVEF%. LVEF is significantly lower among patients with fQRS than patients with not fQRS in NSTEMI patients while there is no significant difference of LVEF % between both groups in unstable angina patients. There is significant association between fQRS and higher prevalence of NSTEMI and higher incidence of heart failure, arrhythmia and bad outcome. By multivariate analysis, NSTEMI (p =0.003) and high HR (p =0.004) and fragmented QRS (p =0.00) were the only significant predictors for bad outcome. FQRS have the ability to diagnose NSTEMI in 47.9% of cases, fQRs can truly exclude NSTEMI in 72.7% of case. Conclusion: Among patients with ACS, the presence of fQRS was associated with an increase incidence of complication, worse outcome, larger LV dimensions, and lower LVEF. The presence of fQRS in acute coronary syndrome patients could predict the presence of NSTEMI with fair diagnostic value.

Published in	Cardiology and Cardiovascular Research (Volume 3, Issue 3)
DOI	10.11648/j.ccr.20190303.16
Page(s)	71-79
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

ACS (NSTEMI, Unstable Angina), Fragmented QRS Complex, Hospital Outcome

References

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APA Style

Hanan Ibrahim Radwan, Kamal Saad Mansour, Mohammed Mustafa Al-Daydamony, Reema Saed Mohammed. (2019). Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome. Cardiology and Cardiovascular Research, 3(3), 71-79. https://doi.org/10.11648/j.ccr.20190303.16

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ACS Style

Hanan Ibrahim Radwan; Kamal Saad Mansour; Mohammed Mustafa Al-Daydamony; Reema Saed Mohammed. Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome. Cardiol. Cardiovasc. Res. 2019, 3(3), 71-79. doi: 10.11648/j.ccr.20190303.16

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AMA Style

Hanan Ibrahim Radwan, Kamal Saad Mansour, Mohammed Mustafa Al-Daydamony, Reema Saed Mohammed. Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome. Cardiol Cardiovasc Res. 2019;3(3):71-79. doi: 10.11648/j.ccr.20190303.16

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@article{10.11648/j.ccr.20190303.16,
  author = {Hanan Ibrahim Radwan and Kamal Saad Mansour and Mohammed Mustafa Al-Daydamony and Reema Saed Mohammed},
  title = {Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome},
  journal = {Cardiology and Cardiovascular Research},
  volume = {3},
  number = {3},
  pages = {71-79},
  doi = {10.11648/j.ccr.20190303.16},
  url = {https://doi.org/10.11648/j.ccr.20190303.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20190303.16},
  abstract = {Background: To detect the potential in hospital prognostic value of fQRS complex in patients with acute coronary syndrome (ACS) & investigate whether FQRS complex can be used to distinguish patients with early NSTEMI from those with unstable angina. Methods: It included 150 patients with acute NSTEMI and unstable angina. All patients were subjected to Grace score calculation, ECG to detect ischemic changes and detect presence or absent of fQRS, transthoracic echo to detect LV ejection fraction and recording in-hospital outcome. Results: Patients with fQRS have significant higher Killip class>2, higher troponin &CKMB levels, higher grace score, increased LVEDD & LVESD and significantly lower LVEF%. LVEF is significantly lower among patients with fQRS than patients with not fQRS in NSTEMI patients while there is no significant difference of LVEF % between both groups in unstable angina patients. There is significant association between fQRS and higher prevalence of NSTEMI and higher incidence of heart failure, arrhythmia and bad outcome. By multivariate analysis, NSTEMI (p =0.003) and high HR (p =0.004) and fragmented QRS (p =0.00) were the only significant predictors for bad outcome. FQRS have the ability to diagnose NSTEMI in 47.9% of cases, fQRs can truly exclude NSTEMI in 72.7% of case. Conclusion: Among patients with ACS, the presence of fQRS was associated with an increase incidence of complication, worse outcome, larger LV dimensions, and lower LVEF. The presence of fQRS in acute coronary syndrome patients could predict the presence of NSTEMI with fair diagnostic value.},
 year = {2019}
}

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TY  - JOUR
T1  - Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome
AU  - Hanan Ibrahim Radwan
AU  - Kamal Saad Mansour
AU  - Mohammed Mustafa Al-Daydamony
AU  - Reema Saed Mohammed
Y1  - 2019/09/23
PY  - 2019
N1  - https://doi.org/10.11648/j.ccr.20190303.16
DO  - 10.11648/j.ccr.20190303.16
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 71
EP  - 79
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20190303.16
AB  - Background: To detect the potential in hospital prognostic value of fQRS complex in patients with acute coronary syndrome (ACS) & investigate whether FQRS complex can be used to distinguish patients with early NSTEMI from those with unstable angina. Methods: It included 150 patients with acute NSTEMI and unstable angina. All patients were subjected to Grace score calculation, ECG to detect ischemic changes and detect presence or absent of fQRS, transthoracic echo to detect LV ejection fraction and recording in-hospital outcome. Results: Patients with fQRS have significant higher Killip class>2, higher troponin &CKMB levels, higher grace score, increased LVEDD & LVESD and significantly lower LVEF%. LVEF is significantly lower among patients with fQRS than patients with not fQRS in NSTEMI patients while there is no significant difference of LVEF % between both groups in unstable angina patients. There is significant association between fQRS and higher prevalence of NSTEMI and higher incidence of heart failure, arrhythmia and bad outcome. By multivariate analysis, NSTEMI (p =0.003) and high HR (p =0.004) and fragmented QRS (p =0.00) were the only significant predictors for bad outcome. FQRS have the ability to diagnose NSTEMI in 47.9% of cases, fQRs can truly exclude NSTEMI in 72.7% of case. Conclusion: Among patients with ACS, the presence of fQRS was associated with an increase incidence of complication, worse outcome, larger LV dimensions, and lower LVEF. The presence of fQRS in acute coronary syndrome patients could predict the presence of NSTEMI with fair diagnostic value.
VL  - 3
IS  - 3
ER  -

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Author Information

Hanan Ibrahim Radwan

Cardiology Department, Zagazig University, Zagazig, Egypt
Kamal Saad Mansour

Cardiology Department, Zagazig University, Zagazig, Egypt
Mohammed Mustafa Al-Daydamony

Cardiology Department, Zagazig University, Zagazig, Egypt
Reema Saed Mohammed

Cardiology Department, Al-Margab University, Alkhoms, Libya

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APA Style

Hanan Ibrahim Radwan, Kamal Saad Mansour, Mohammed Mustafa Al-Daydamony, Reema Saed Mohammed. (2019). Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome. Cardiology and Cardiovascular Research, 3(3), 71-79. https://doi.org/10.11648/j.ccr.20190303.16

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ACS Style

Hanan Ibrahim Radwan; Kamal Saad Mansour; Mohammed Mustafa Al-Daydamony; Reema Saed Mohammed. Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome. Cardiol. Cardiovasc. Res. 2019, 3(3), 71-79. doi: 10.11648/j.ccr.20190303.16

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AMA Style

Hanan Ibrahim Radwan, Kamal Saad Mansour, Mohammed Mustafa Al-Daydamony, Reema Saed Mohammed. Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome. Cardiol Cardiovasc Res. 2019;3(3):71-79. doi: 10.11648/j.ccr.20190303.16

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@article{10.11648/j.ccr.20190303.16,
  author = {Hanan Ibrahim Radwan and Kamal Saad Mansour and Mohammed Mustafa Al-Daydamony and Reema Saed Mohammed},
  title = {Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome},
  journal = {Cardiology and Cardiovascular Research},
  volume = {3},
  number = {3},
  pages = {71-79},
  doi = {10.11648/j.ccr.20190303.16},
  url = {https://doi.org/10.11648/j.ccr.20190303.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20190303.16},
  abstract = {Background: To detect the potential in hospital prognostic value of fQRS complex in patients with acute coronary syndrome (ACS) & investigate whether FQRS complex can be used to distinguish patients with early NSTEMI from those with unstable angina. Methods: It included 150 patients with acute NSTEMI and unstable angina. All patients were subjected to Grace score calculation, ECG to detect ischemic changes and detect presence or absent of fQRS, transthoracic echo to detect LV ejection fraction and recording in-hospital outcome. Results: Patients with fQRS have significant higher Killip class>2, higher troponin &CKMB levels, higher grace score, increased LVEDD & LVESD and significantly lower LVEF%. LVEF is significantly lower among patients with fQRS than patients with not fQRS in NSTEMI patients while there is no significant difference of LVEF % between both groups in unstable angina patients. There is significant association between fQRS and higher prevalence of NSTEMI and higher incidence of heart failure, arrhythmia and bad outcome. By multivariate analysis, NSTEMI (p =0.003) and high HR (p =0.004) and fragmented QRS (p =0.00) were the only significant predictors for bad outcome. FQRS have the ability to diagnose NSTEMI in 47.9% of cases, fQRs can truly exclude NSTEMI in 72.7% of case. Conclusion: Among patients with ACS, the presence of fQRS was associated with an increase incidence of complication, worse outcome, larger LV dimensions, and lower LVEF. The presence of fQRS in acute coronary syndrome patients could predict the presence of NSTEMI with fair diagnostic value.},
 year = {2019}
}

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TY  - JOUR
T1  - Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome
AU  - Hanan Ibrahim Radwan
AU  - Kamal Saad Mansour
AU  - Mohammed Mustafa Al-Daydamony
AU  - Reema Saed Mohammed
Y1  - 2019/09/23
PY  - 2019
N1  - https://doi.org/10.11648/j.ccr.20190303.16
DO  - 10.11648/j.ccr.20190303.16
T2  - Cardiology and Cardiovascular Research
JF  - Cardiology and Cardiovascular Research
JO  - Cardiology and Cardiovascular Research
SP  - 71
EP  - 79
PB  - Science Publishing Group
SN  - 2578-8914
UR  - https://doi.org/10.11648/j.ccr.20190303.16
AB  - Background: To detect the potential in hospital prognostic value of fQRS complex in patients with acute coronary syndrome (ACS) & investigate whether FQRS complex can be used to distinguish patients with early NSTEMI from those with unstable angina. Methods: It included 150 patients with acute NSTEMI and unstable angina. All patients were subjected to Grace score calculation, ECG to detect ischemic changes and detect presence or absent of fQRS, transthoracic echo to detect LV ejection fraction and recording in-hospital outcome. Results: Patients with fQRS have significant higher Killip class>2, higher troponin &CKMB levels, higher grace score, increased LVEDD & LVESD and significantly lower LVEF%. LVEF is significantly lower among patients with fQRS than patients with not fQRS in NSTEMI patients while there is no significant difference of LVEF % between both groups in unstable angina patients. There is significant association between fQRS and higher prevalence of NSTEMI and higher incidence of heart failure, arrhythmia and bad outcome. By multivariate analysis, NSTEMI (p =0.003) and high HR (p =0.004) and fragmented QRS (p =0.00) were the only significant predictors for bad outcome. FQRS have the ability to diagnose NSTEMI in 47.9% of cases, fQRs can truly exclude NSTEMI in 72.7% of case. Conclusion: Among patients with ACS, the presence of fQRS was associated with an increase incidence of complication, worse outcome, larger LV dimensions, and lower LVEF. The presence of fQRS in acute coronary syndrome patients could predict the presence of NSTEMI with fair diagnostic value.
VL  - 3
IS  - 3
ER  -

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