Cargando…
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...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574772/ https://www.ncbi.nlm.nih.gov/pubmed/33117185 http://dx.doi.org/10.3389/fphys.2020.01027 |
_version_ | 1783597689884114944 |
---|---|
author | Luo, Gongming Li, Qian Duan, Jingwei Peng, Yu Zhang, Zheng |
author_facet | Luo, Gongming Li, Qian Duan, Jingwei Peng, Yu Zhang, Zheng |
author_sort | Luo, Gongming |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-7574772 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75747722020-10-27 The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis Luo, Gongming Li, Qian Duan, Jingwei Peng, Yu Zhang, Zheng Front Physiol Physiology 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. Frontiers Media S.A. 2020-10-06 /pmc/articles/PMC7574772/ /pubmed/33117185 http://dx.doi.org/10.3389/fphys.2020.01027 Text en Copyright © 2020 Luo, Li, Duan, Peng and Zhang. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Physiology Luo, Gongming Li, Qian Duan, Jingwei Peng, Yu Zhang, Zheng The Predictive Value of Fragmented QRS for Cardiovascular Events in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis |
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 | Physiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7574772/ https://www.ncbi.nlm.nih.gov/pubmed/33117185 http://dx.doi.org/10.3389/fphys.2020.01027 |
work_keys_str_mv | AT luogongming thepredictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis AT liqian thepredictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis AT duanjingwei thepredictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis AT pengyu thepredictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis AT zhangzheng thepredictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis AT luogongming predictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis AT liqian predictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis AT duanjingwei predictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis AT pengyu predictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis AT zhangzheng predictivevalueoffragmentedqrsforcardiovasculareventsinacutemyocardialinfarctionasystematicreviewandmetaanalysis |