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Eur. J. Clin. Invest. · Feb 2020
Meta AnalysisPredictive value of fragmented QRS for ventricular tachyarrhythmias in patients with acute myocardial infarction: A meta-analysis.
- Shangbo Xu, Lihua Yang, Danhua Hong, Lan Chen, and Xin Wang.
- Department of Cardiology, First Affiliated Hospital of Shantou University Medical College, Shantou, China.
- Eur. J. Clin. Invest. 2020 Feb 1; 50 (2): e13182.
BackgroundRecent studies indicated that fragmented QRS (fQRS) is associated with malignant cardiac arrhythmias in patients with acute myocardial infarction (AMI). However, a systematic review and meta-analysis on this issue still have not been conducted. Thus, we performed a systematic review and meta-analysis to access the predictive value of fQRS for ventricular tachyarrhythmias (VTAs) in patients with AMI.Materials And MethodsWe searched the databases of PubMed, Embase and Cochrane Library for relevant studies until 8 June 2019. We included studies which compared VTAs in AMI patients with fQRS vs without fQRS.ResultsSix studies enrolling 2218 ST-segment elevation myocardial infarction (STEMI) patients were included in this meta-analysis. The fQRS was significantly associated with greater risk of VTAs in STEMI patients (Odds ratio [OR] 2.81, 95% confidence interval (CI) 1.99-3.95, P < .00001; I2 = 30%). This association was still significant both in prospective (OR 3.25, 95% CI 1.94-5.46, P < .00001; I2 = 0%) and retrospective (OR 2.40, 95% CI 1.22-4.74, P = .01; I2 = 54%) studies. In particularly, fQRS in patients with low left ventricular ejection fraction (≤50%) (OR 2.97, 95% CI 1.88-4.70, P < .00001; I2 = 21%) or <60 years old (OR 3.07, 95% CI 2.02-4.66, P < .00001; I2 = 0%) tripled the risk of VTAs during AMI.ConclusionOur meta-analysis demonstrated that fQRS increases the risk of developing VTAs in patients with STEMI.© 2019 Stichting European Society for Clinical Investigation Journal Foundation.
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