Prognostic Value of QRS Complex Fragmentation in Patients with Acute Anterior STEMI undergoing Primary PCI During in-Hospital Stay

Abstract Background Primary percutaneous coronary intervention (PCI) as a type of coronary reperfusion therapy may lead to recanalization and improved myocardial reperfusion in patients with ST elevation myocardial infarction (STEMI). Aim of the Work The aim of our study is sought to investigate the prevelance of fQRS complex in ECG of patients admitted with acute anterior STEMI undergoing primary PCI and its short-term prognostic value during hospital stay. Patient and Methods In the current study, 156 consecutive patients with anterior STEMI being treated with primary PCI between July 2021 and March 2022 were enrolled. Patients were included in the study if they presented with symptoms that were identified typically as typical chest pain lasting for more than 20 min; had ST-segment elevation ≥1 mm in two contiguous electrocardiographic and had undergone primary PCI including balloon angioplasty, thrombus aspira tion and/or stent implantation. Results Our results study showed that, in patients with a diagnosis of anterior STEMI, the presence of fQRS at admission ECG is associated with the development of MACE at short-term follow-up and higher mortality. In addition, fQRS was the strongest predictor of MACE in patients with acute MI after adjustment for the risk factors of ischemic heart disease. Conclusion Prevalence of fQRS complex on admission ECG in patients with acute anterior STEMI undergoing primary PCI is common. Presence of fQRS in these patients has independently predicted prognosis regarding LVEF values, Cath lab events, MACE and mortality during hospital stay. Therefore, fQRS can be incorporated in risk stratification tools and help in management of patients with acute anterior STEMI undergoing primary PCI.