Impact of fragmented QRS on in-hospital mortality in emergency coronary artery bypass grafting for STEMI: A retrospective analysis

Year 2024, Volume: 37 Issue: 2, 121 - 128, 31.05.2024

Mehmet Altunova , Gul Cakmak

https://doi.org/10.5472/marumj.1485355

Abstract

Objective: Fragmented QRS complex (fQRS) is associated with increased morbidity and mortality, sudden cardiac death, and recurrent
cardiovascular events. The role of coronary artery bypass grafting (CABG) in the primary treatment of acute myocardial infarction
remains controversial. In this study, we aimed to assess the predictive value of fQRS in-hospital mortality among acute segment
elevation myocardial infarction (STEMI) patients undergoing emergency CABG for primary revascularization.
Patients and Methods: Between 2010 and 2020, we retrospectively included 99 consecutive STEMI patients who were not eligible for
primary percutaneous intervention and required emergency CABG. The study population was divided into two groups: survivors and
non-survivors. We compared the two groups regarding demographic, clinical, and operative characteristics.
Results: fQRS was identified as an independent predictor of in-hospital mortality (p = 0.037). Additionally, left ventricular ejection
fraction (LVEF) was an independent predictor of in-hospital mortality (p = 0.028). Glomerular filtration rate (GFR), glucose levels,
and Killip class ≥ III were significantly associated with in-hospital mortality (p = 0.002), (p = 0.001) and (p < 0.001).
Conclusion: fQRS emerged as an independent predictor of in-hospital mortality among patients undergoing emergency CABG for
primary revascularization in cases of STEMI.

Keywords

Fragmented QRS, ST-elevation myocardial infarction, Coronary artery bypass grafting, Mortality

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