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CLC number: R542.22

On-line Access: 2018-05-05

Received: 2017-09-19

Revision Accepted: 2018-03-19

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Journal of Zhejiang University SCIENCE B 2018 Vol.19 No.5 P.349-353

10.1631/jzus.B1700413


Combining fragmented QRS and TIMI score for predicting in-hospital short-term prognosis after acute myocardial infarction


Author(s):  Qin-Hui Sheng, Chih Chi Hsu, Jian-Ping Li, Tao Hong, Yong Huo

Affiliation(s):  Department of Cardiology, Peking University First Hospital, Beijing 100034, China

Corresponding email(s):   shengqinhui@126.com

Key Words:  Acute myocardial infarction (AMI), Freagmented QRS (fQRS), TIMI score


Qin-Hui Sheng, Chih Chi Hsu, Jian-Ping Li, Tao Hong, Yong Huo. Combining fragmented QRS and TIMI score for predicting in-hospital short-term prognosis after acute myocardial infarction[J]. Journal of Zhejiang University Science B, 2018, 19(5): 349-353.

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author="Qin-Hui Sheng, Chih Chi Hsu, Jian-Ping Li, Tao Hong, Yong Huo",
journal="Journal of Zhejiang University Science B",
volume="19",
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pages="349-353",
year="2018",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1700413"
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%T Combining fragmented QRS and TIMI score for predicting in-hospital short-term prognosis after acute myocardial infarction
%A Qin-Hui Sheng
%A Chih Chi Hsu
%A Jian-Ping Li
%A Tao Hong
%A Yong Huo
%J Journal of Zhejiang University SCIENCE B
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%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1700413

TY - JOUR
T1 - Combining fragmented QRS and TIMI score for predicting in-hospital short-term prognosis after acute myocardial infarction
A1 - Qin-Hui Sheng
A1 - Chih Chi Hsu
A1 - Jian-Ping Li
A1 - Tao Hong
A1 - Yong Huo
J0 - Journal of Zhejiang University Science B
VL - 19
IS - 5
SP - 349
EP - 353
%@ 1673-1581
Y1 - 2018
PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.B1700413


Abstract: 
acute myocardial infarction (AMI) has a high mortality rate and poor prognosis for patients. The primary causes of death are arrhythmia and heart failure. For patients admitted because of myocardial infarction, various risk evaluations are initiated to foresee possible complications. The thrombolysis in myocardial infarction (TIMI) risk score, which can be used to predict the prognosis and the need for revascularisation, is the most convenient and commonly used system, but is inadequate for AMI patients on admittance. Fragmented QRS (fQRS) has been shown to be a valuable electrocardiographic (ECG) index for predicting the prognosis of patients with coronary heart disease. Also, fQRS is considered to predict an increased likelihood of a poor outcome and mortality in patients with coronary artery disease (CAD), even for some successfully revascularized AMI patients. So what would happen if fQRS and the TIMI risk score were combined? This study focused on the investigation of the short-term prognostic value of fQRS combined with the TIMI risk score for patients with AMI.

碎裂QRS波联合TIMI危险评分预测急性心肌 梗死患者的短期预后

目的:探讨碎裂QRS波(fQRS)联合心肌梗死溶栓治疗临床试验(TIMI)危险评分对急性心肌梗死(AMI)患者短期预后的评估价值.
创新点:TIMI危险评分常用于AMI患者入院即刻的风险评估,TIMI评分<4分的患者被评定为中危组.本研究发现,无论TIMI评分如何,出现fQRS而未行经皮冠状动脉介入治疗(PCI)的患者,其死亡率均显著升高.fQRS联合TIMI危险评分更利于AMI患者的预后评估,TIMI评分<4分但同时合并fQRS的患者,可以从早期PCI介入治疗获益.
方法:回顾300例AMI患者的临床资料及院内诊治经过,记录分析患者fQRS出现的时间、部位及其他临床转归,评价fQRS联合TIMI危险评分与患者临床预后的关系.
结论:(1)fQRS联合TIMI危险评分可提高恶性心律失常、左室收缩功能不全(LVSD)和死亡预测的敏感度和特异度;(2)fQRS阳性的AMI患者,进行早期血运重建可降低患者心血管事件发生率,fQRS可能作为TIMI评分<4分患者早期介入治疗的指征.

关键词:急性心肌梗死;碎裂QRS波;TIMI危险评分

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Reference

[1]Antman EM, Cohen M, Bernink PJ, et al., 2000. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA, 284(7):835-842.

[2]Bekler A, Barutçu A, Tenekecioglu E, et al., 2015. The relationship between fragmented QRS complexes and SYNTAX and Gensini scores in patients with acute coronary syndrome. Kardiol Pol, 73(4):246-254.

[3]Das MK, Khan B, Jacob S, et al., 2006. Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease. Circulation, 113(21):2495-2501.

[4]Das MK, Saha C, El Masry H, et al., 2007. Fragmented QRS on a 12-lead ECG: a predictor of mortality and cardiac events in patients with coronary artery disease. Heart Rhythm, 4(11):1385-1392.

[5]Das MK, Michael MA, Suradi H, et al., 2009. Usefulness of fragmented QRS on a 12-lead electrocardiogram in acute coronary syndrome for predicting mortality. Am J Cardiol, 104(12):1631-1637.

[6]El-Dosouky II, Abomandour HG, 2017. Fragmented QRS complex as a predictor of coronary artery disease in patients with acute coronary syndrome (A study from Egypt). Indian Heart J, 69(2):289-290.

[7]Eyuboglu M, Kucuk U, Senarslan O, et al., 2017. Comparison of the presence of fragmented QRS complexes in the inferior versus the anterior leads for predicting coronary artery disease severity. Rev Port Cardiol, 36(2):89-93.

[8]Güngör B, Özcan KS, Karataş MB, et al., 2016. Prognostic value of QRS fragmentation in patients with acute myocardial infarction: a meta-analysis. Ann Noninvasive Electrocardiol, 21(6):604-612.

[9]Liu JC, Kou LY, Zhang LY, 2010. The effect of early revascuarlization on myocardial scarring and cardiac function. Clin Med China, 7:712-714 (in Chinese).

[10]Morita H, Kusano KF, Miura D, et al., 2008. Fragmented QRS as a marker of conduction abnormality and a predictor of prognosis of Brugada syndrome. Circulation, 118(17):1697-1704.

[11]Sheng QH, Hsu CC, Li JP, et al., 2014. Correlation between fragmented QRS and the short-term prognosis of patients with acute myocardial infarction. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 15(1):67-74.

[12]Tanriverdi Z, Dursun H, Colluoglu T, et al., 2017. Single derivation fragmented QRS can predict poor prognosis in successfully revascularized acute STEMI patients. Arq Bras Cardiol, 109(3):213-221.

[13]Wang Y, Zhao HN, 2011. Investigation of changing and significance of connexin43, [Ca2+]i and apoptosis in early phase of acute myocardial ischemia. Chin J Cardiac Pacing Electrophysiol, 4(25):349-352 (in Chinese).

[14]Zhang RX, Chen SY, Zhao Q, et al., 2017. Fragmented QRS complex is a prognostic marker of microvascular reperfusion and changes in LV function occur in patients with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention. Exp Ther Med, 13(6):3231-3238.

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