The Correlation Between Fragmented QRS Complexes And Coronary Artery Lesion In Patients With Non-ST-segment Elevation Acute Coronary Syndrome

ObjectiveThe study is to observe the characteristic of fragmented QRS complexes(f QRS)in patients with non-ST-segment elevation acute coronary syndrome(NSTE-ACS),to define the role of f QRS in evaluating the extent and severity of coronary artery lesion.MethodA total of 168 NSTE-ACS patients were included,who were admitted to Fujian medical university affiliated Quan zhou first hospital from March 2015 to March 2016.The patients were divided into f QRS(+)group and f QRS(-)group according to the appearance of f QRS on electrocardiogram(ECG).Based on the calculation of GRACE score,The patients can be divided into low risk group(1-108)?medium risk group(109-140)and high risk group(>140).Meanwhile,based on the calculation of SYNTAX score,The patients also can be divided into low risk group(0-22)?medium risk group(23-33)and high risk group(>33).The characteristic of f QRS were analyzed in the different group of GRACE score and the different group of SYNTAX score.The data were analyzed by IBM SPSS 23.0 statistical software,the tests were used two-sided test,P<0.05 believes that the difference was statistically significant.Result1.1 The study showed that there was no difference in age,sex,hypertension,diabetes,TC,TG,CK,CK-MB and Scr between f QRS(+)group and f QRS(-)groups,but smoking was significant difference between the two groups(P<0.05).1.2 The Spearman correlation analysis showed a positive and significant correlation between the appearance of f QRS and the GRACE scores(r=0.251,P<0.05).1.3 The Spearman correlation analysis showed that a positive and significant correlation was found between the appearance of f QRS and the SYNTAX scores(r=0.639,P<0.05).2.1 The results showed that there was no difference in gender,smoking,hypertension,diabetes,TC and TG among the groups with different risk stratification.2.2 It showed significant difference between the appearance of f QRS in the different GRACE score groups(P<0.05).2.3 It showed significant difference among the SYNTAX score in the different GRACE score groups(P<0.05).3.1 The study showed that there was obvious difference in age,gender,smoking and hypertension among different risk degree of SYNTAX score(P<0.05);there was no statistically significant difference in diabetes,TC,TG,CK,CK-MB and Scr.3.2 The study showed that there was significant difference in LM,LAD,LCX and RCA between the opposite appearance of f QRS(P<0.05).3.3 It showed significant difference between the number of coronary lesions in the opposite appearance of f QRS(P<0.05).3.4 The Spearman correlation analysis also showed a positive and significant correlation between the appearance of f QRS and the coronary artery lesions(r=0.491,P<0.05).3.5 The difference of f QRS detection rate among different leads was significantly lower than that of the anterior wall and lateral wall,and the difference between the two groups was statistically significant(P<0.05).3.6 There was significant difference among the different SYNTAX score stratification groups in the f QRS(+)group(P<0.05).3.7 The Spearman correlation analysis also showed a positive and significant correlation between different number of f QRS and the SYNTAX score(r=0.615,P<0.05).3.8 The Spearman correlation analysis also showed a positive and significant correlation between the number of coronary lesions and the SYNTAX score(r=0.759,P<0.05).3.9 The Logistic regression analysis showed that SYNTAX integration(OR=11.272,95%CI: 3.778-33.635,P<0.05)is an independent risk factors for NSTE-ACS patients to form f QRS.ConclusionFor the NSTE-ACS patients,the GRACE score were correlated with f QRS,and the SYNTAX score also have been associated with f QRS.It is speculated that f QRS can be used to predict the risk of adverse cardiovascular events in NSTE-ACS patients.It can also be used to evaluate the range of patients and lesions.And there are some warning function for screening high-risk patients early.