QRS Fragmentation as a Prognostic Test in Acute Coronary Syndrome

Copyright © 2013 Tarek M. Abdelrahman. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background-Rationale of the Study: Among several invasive and non-invasive tests for risk stratification of acute coronary syndromes (ACS), fewer markers can be utilized in clinical practice. Our rationale is to validate use of QRS-fragmentation as a promising bed-side test for assessment of prognosis in those patients. Methods and Results: Collection of two-hundred and twenty patients with ACS was done during two years (from January 2011 till January 2013). Significant organic vaLVe disease and QRS duration ≥ 120 ms as well as patients with permanent pacemakers were excluded. Patients were subjected to full clinical examination, ECG and Echocardiography in the first day of admission followed by diagnostic coronary angiography before discharge and a nuclear study was done for Randomized sample from each group. 12-leads ECG revealed fragmentation of QRS in 74 patients and 146 patients with no QRS fragmentation. Localization of the infarct site revealed NS difference between percentages in both groups. Echocardiography revealed a significant deterioration of LV functions in group-A than group-B. Also, MR jet area was significantly higher in group-A. Coronary angiography revealed severer lesions in group-A more than group-B. Nuclear study revealed higher percentages of irreversible scars in group-A (30%) and higher reversibility in group-B (80%). In-hospita