A New Revised Cardiac Risk Index Incorporating Fragmented QRS Complex as a Prognostic Marker in Patients Undergoing Noncardiac Vascular Surgery

The aim of this study was to investigate the value of a new Revised Cardiac Risk Index (RCRI) that includes consideration of QRS fragmentation (fQRS) as a predictor of cardiac events in patients undergoing noncardiac vascular surgery. Four hundred sixty-seven consecutive patients admitted for noncar...

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Bibliographic Details
Published in:The American journal of cardiology 2013-07, Vol.112 (1), p.122-127
Main Authors: Bae, Myung Hwan, MD, Jang, Se Yong, MD, Choi, Won Suk, MD, Kim, Kyun Hee, MD, Park, Sun Hee, MD, Lee, Jang Hoon, MD, Kim, Hyung Kee, MD, Yang, Dong Heon, MD, Huh, Seung, MD, Park, Hun Sik, MD, Cho, Yongkeun, MD, Chae, Shung Chull, MD
Format: Article
Language:English
Subjects:
Aged
Cardiac arrhythmia
Cardiovascular
Cardiovascular disease
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - etiology
Cardiovascular Diseases - physiopathology
Chi-Square Distribution
Comorbidity
Electrocardiography
Female
Heart attacks
Heart failure
Humans
Logistic Models
Male
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment - methods
Risk Factors
ROC Curve
Tomography, Emission-Computed, Single-Photon
Vascular Surgical Procedures
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Summary:The aim of this study was to investigate the value of a new Revised Cardiac Risk Index (RCRI) that includes consideration of QRS fragmentation (fQRS) as a predictor of cardiac events in patients undergoing noncardiac vascular surgery. Four hundred sixty-seven consecutive patients admitted for noncardiac vascular surgery were studied. Patients were allocated to RCRI 0, 1, 2, or ≥3 groups according to the sum of diabetes, renal insufficiency, and histories of ischemic heart disease, congestive heart failure, and cerebrovascular disease. They were then reallocated to fragmented RCRI (fRCRI) 0, 1, 2, or ≥3 groups after including a score of 1 or 0 corresponding to the presence or absence of fQRS. A major adverse cardiac event (MACE) was defined as a composite of death, myocardial infarction, congestive heart failure, and percutaneous coronary intervention before noncardiac vascular surgery. During index hospitalization, MACE developed in 38 patients (8.1%). fQRS was present in 169 (36.2%), and it was significantly greater in patients with MACE than in those without MACE (63.2% vs 34.3%, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2013.02.066