The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis
Objective: Fragmented QRS (fQRS) have been reported as a predictor of major adverse cardiac events (MACE) and mortality in several studies on cardiovascular disease. However, most studies have yielded discrepant results. This study aimed to explore the correlation between fQRS and cardiovascular eve...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-10-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2020.01027/full |
| _version_ | 1828809384268922880 |
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| author | Gongming Luo Gongming Luo Qian Li Jingwei Duan Jingwei Duan Yu Peng Yu Peng Zheng Zhang Zheng Zhang Zheng Zhang |
| author_facet | Gongming Luo Gongming Luo Qian Li Jingwei Duan Jingwei Duan Yu Peng Yu Peng Zheng Zhang Zheng Zhang Zheng Zhang |
| author_sort | Gongming Luo |
| collection | DOAJ |
| description | Objective: Fragmented QRS (fQRS) have been reported as a predictor of major adverse cardiac events (MACE) and mortality in several studies on cardiovascular disease. However, most studies have yielded discrepant results. This study aimed to explore the correlation between fQRS and cardiovascular events in patients with acute myocardial infarction (AMI) during their hospital stay and follow-up period, and the predictive value of fQRS in the prognosis of AMI.Methods: We searched for relevant studies in four databases, Medline, Embase, PubMed, and the Cochrane Library from January 2010 to March 2020. Our initial search yielded 585 articles. Of these, we screened 19 studies, and finally included a total of 6,914 patients in this analysis, comparing death events or MACE in AMI patients with or without fQRS.Results: Fragmented QRS was significantly associated with a higher risk of in-hospital mortality (OR, 3.97; 95% CI, 2.45–6.44; p < 0.00001), long-term mortality (OR, 2.93; 95% CI, 1.76–4.88; p < 0.0001), in-hospital MACE (OR, 2.48; 95% CI, 1.62–3.80; p < 0.0001), and long-term MACE (OR, 3.81; 95% CI, 2.21–6.57; p < 0.00001). In particular, it demonstrated a higher predictive value for in-hospital cardiovascular mortality and long-term all-cause mortality in AMI patients and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI). Moreover, fQRS was also associated with an increased risk of ventricular arrhythmias (OR, 2.76; 95% CI, 1.72–4.43; p < 0.0001) and heart failure (OR, 1.65; 95% CI, 1.02–2.66; p = 0.04). Fragmented QRS was negatively associated with left ventricular ejection function (LVEF) (MD, −5.47; CI, [−7.03, −3.91]; p < 0.00001) and positively associated with a high incidence of coronary artery triple vessel lesions (OR, 2.14; 95% CI, 1.31–3.51; p = 0.002) in AMI patients.Conclusion: Fragmented QRS is significantly associated with in-hospital and long-term mortality and MACE in patients with AMI, as well as ventricular arrhythmias and heart failure. Furthermore, it may be a marker of mortality and MACE risk. Moreover, fQRS also indicates a reduced LVEF and a high incidence of coronary artery triple vessel lesions in AMI patients.Meta-analysis Registration:https://www.crd.york.ac.uk/prospero; ID: CRD42020171668. |
| first_indexed | 2024-12-12T08:55:46Z |
| format | Article |
| id | doaj.art-97db5dc90d644fac898fc5797a450e01 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-12T08:55:46Z |
| publishDate | 2020-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-97db5dc90d644fac898fc5797a450e012022-12-22T00:30:00ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2020-10-011110.3389/fphys.2020.01027561842The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-AnalysisGongming Luo0Gongming Luo1Qian Li2Jingwei Duan3Jingwei Duan4Yu Peng5Yu Peng6Zheng Zhang7Zheng Zhang8Zheng Zhang9The First School of Clinical Medicine, Lanzhou University, Lanzhou, ChinaHeart Center, the First Hospital of Lanzhou University, Lanzhou, ChinaThe First School of Clinical Medicine, Lanzhou University, Lanzhou, ChinaThe First School of Clinical Medicine, Lanzhou University, Lanzhou, ChinaHeart Center, the First Hospital of Lanzhou University, Lanzhou, ChinaThe First School of Clinical Medicine, Lanzhou University, Lanzhou, ChinaGansu Key Laboratory of Cardiovascular Disease, Lanzhou, ChinaThe First School of Clinical Medicine, Lanzhou University, Lanzhou, ChinaHeart Center, the First Hospital of Lanzhou University, Lanzhou, ChinaGansu Key Laboratory of Cardiovascular Disease, Lanzhou, ChinaObjective: Fragmented QRS (fQRS) have been reported as a predictor of major adverse cardiac events (MACE) and mortality in several studies on cardiovascular disease. However, most studies have yielded discrepant results. This study aimed to explore the correlation between fQRS and cardiovascular events in patients with acute myocardial infarction (AMI) during their hospital stay and follow-up period, and the predictive value of fQRS in the prognosis of AMI.Methods: We searched for relevant studies in four databases, Medline, Embase, PubMed, and the Cochrane Library from January 2010 to March 2020. Our initial search yielded 585 articles. Of these, we screened 19 studies, and finally included a total of 6,914 patients in this analysis, comparing death events or MACE in AMI patients with or without fQRS.Results: Fragmented QRS was significantly associated with a higher risk of in-hospital mortality (OR, 3.97; 95% CI, 2.45–6.44; p < 0.00001), long-term mortality (OR, 2.93; 95% CI, 1.76–4.88; p < 0.0001), in-hospital MACE (OR, 2.48; 95% CI, 1.62–3.80; p < 0.0001), and long-term MACE (OR, 3.81; 95% CI, 2.21–6.57; p < 0.00001). In particular, it demonstrated a higher predictive value for in-hospital cardiovascular mortality and long-term all-cause mortality in AMI patients and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI). Moreover, fQRS was also associated with an increased risk of ventricular arrhythmias (OR, 2.76; 95% CI, 1.72–4.43; p < 0.0001) and heart failure (OR, 1.65; 95% CI, 1.02–2.66; p = 0.04). Fragmented QRS was negatively associated with left ventricular ejection function (LVEF) (MD, −5.47; CI, [−7.03, −3.91]; p < 0.00001) and positively associated with a high incidence of coronary artery triple vessel lesions (OR, 2.14; 95% CI, 1.31–3.51; p = 0.002) in AMI patients.Conclusion: Fragmented QRS is significantly associated with in-hospital and long-term mortality and MACE in patients with AMI, as well as ventricular arrhythmias and heart failure. Furthermore, it may be a marker of mortality and MACE risk. Moreover, fQRS also indicates a reduced LVEF and a high incidence of coronary artery triple vessel lesions in AMI patients.Meta-analysis Registration:https://www.crd.york.ac.uk/prospero; ID: CRD42020171668.https://www.frontiersin.org/article/10.3389/fphys.2020.01027/fullcardiovascular eventsacute myocardial infarctionfragmented QRSelectrocardiogrammortality |
| spellingShingle | Gongming Luo Gongming Luo Qian Li Jingwei Duan Jingwei Duan Yu Peng Yu Peng Zheng Zhang Zheng Zhang Zheng Zhang The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis Frontiers in Physiology cardiovascular events acute myocardial infarction fragmented QRS electrocardiogram mortality |
| title | The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis |
| title_full | The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis |
| title_fullStr | The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis |
| title_short | The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis |
| title_sort | predictive value of fragmented qrs for cardiovascular events in acute myocardial infarction a systematic review and meta analysis |
| topic | cardiovascular events acute myocardial infarction fragmented QRS electrocardiogram mortality |
| url | https://www.frontiersin.org/article/10.3389/fphys.2020.01027/full |
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