The number of leads with fragmented QRS is independently associated with cardiac death or hospitalization for heart failure in patients with prior myocardial infarction

• Published in: Journal of cardiology 2012-01, Vol.59 (1), p.36-41
• Main Authors: Torigoe, Kumie, MD, Tamura, Akira, MD, Kawano, Yoshiyuki, MD, Shinozaki, Kazuhiro, MD, Kotoku, Munenori, MD, Kadota, Junichi, MD, PhD
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Cardiac death; Cardiovascular; Electrocardiography; Female; Fragmented QRS; Heart failure; Heart Failure - etiology; Heart Failure - mortality; Hospitalization; Humans; Kaplan-Meier Estimate; Kidney Failure, Chronic - complications; Male; Myocardial Infarction - complications; Myocardial Infarction - physiopathology; Prior myocardial infarction; Prognosis; Proportional Hazards Models; Retrospective Studies; Sex Factors; Sodium Potassium Chloride Symporter Inhibitors - therapeutic use; Spironolactone - therapeutic use; Stroke Volume
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2011.09.003

Summary Background No information is currently available on the prognostic significance of the number of leads with fragmented QRS (fQRS). The objective of the study was to clarify the prognostic significance of the number of leads with fQRS in prior myocardial infarction (MI). Methods and results We retrospectively examined 170 patients with prior MI. The primary end point was cardiac death or hospitalization for heart failure. During a mean follow-up period of 6.4 ± 2.9 years, 37 patients developed the primary end point. Univariate Cox proportional hazards regression analyses showed that age, male gender, chronic kidney disease, anterior wall MI, number of leads with fQRS, left ventricular ejection fraction, loop diuretic use, and spironolactone use were significantly associated with the primary end point. A multivariate Cox proportional hazards regression analysis selected age (hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.04–1.14, p < 0.001) and the number of leads with fQRS (HR 1.33, 95% CI 1.11–1.60, p = 0.002) as predictors of the primary end point. A receiver operating characteristic curve analysis showed that the presence of ≥3 leads with fQRS was most useful for distinguishing between patients with and without the primary end point. A Kaplan–Meier analysis showed a lower primary event-free rate in patients with ≥3 leads with fQRS than in those with