• Adem Bekler, Ahmet Barutçu, Erhan Tenekecioglu, Burak Altun, Emine Gazi, Ahmet Temiz, Bahadır Kırılmaz, Muhammed Turgut Alper Ozkan, and Ali Umit Yener.
• Department of Cardiology, Canakkale Onsekiz Mart University, School of Medicine, Canakkale, Turkey. adembekler27@gmail.com.
• Kardiol Pol. 2015 Jan 1; 73 (4): 246-54.

BackgroundFragmented QRS (fQRS) complexes on 12-lead electrocardiography (ECG) have been reported to be predictors of cardiac events and all-cause mortality in coronary artery disease (CAD).AimTo investigate the relationship between fQRS complexes and SYNTAX and Gensini scores in patients with acute coronary syndrome (ACS).MethodsA total of 302 patients (223 men and 79 women) with ACS (133 ST elevated myocardial infarction [STEMI], 107 non-STEMI [NSTEMI], and 62 unstable angina pectoris [USAP]) were evaluated retrospectively in this study. An fQRS pattern was found in 70 patients (fQRS group) but was not found in 232 patients (non-fQRS group). SYNTAX score > 22 and Gensini score > 20 were defined as high SYNTAX and Gensini scores. The relationship between the presence of fQRS on 12-lead ECG and SYNTAX and Gensini scores was assessed.ResultsSYNTAX score (p < 0.001), Gensini score (p < 0.001), NYHA class (p < 0.001), QRS duration (p < 0.001), number of disease vessels (p = 0.003), and high sensitive troponin T levels (p = 0.026) were significantly higher in the fQRS group. The number of fQRS leads (HR 5.79, 95% CI 2.78-12.06, p < 0.001, HR 3.41, 95% CI 1.32-8.78, p = 0.016, respectively) was found to be an independent predictor of high SYNTAX score and high Gensini score in multivariate analysis.ConclusionsThe number of fQRS leads on 12-lead ECG on admission is associated with the severity and complexity of CAD in patients with ACS.

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