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Nanjing Heart Center
Asian Bifurcation Club (ABC)
Nanjing First Hospital, Nanjing Medical University
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Chinese Society of Cardiology (CSC)
Capacity Building and Continuing Education Center,National Health and Family Planning Commission (CBCEC)
American Society for Cardiovascular Angiography and Interventions (SCAI)
Asian Heart Society (AHS)
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Hongjuan Peng :
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Haimei Xu +86-13914736846
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Ling Lin : +86 (25) 52271398
+86-13951884596
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Yingying Zhao :+86-13815408517
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Recommended Paper
Management of Acute Myocardial Infarction During the COVID-19 Pandemic
COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up
CSC Expert Consensus on Principles of Clinical Management of Patients with Severe Emergent Cardiovascular Diseases during the COVID-19 Epidemic
ACC Clinical Bulletin Focuses on Cardiac Implications of Coronavirus (COVID-19)
急性冠脉综合征
Clinical Trial2018 Feb 15;253:20-24.
JOURNAL：Int J Cardiol. Article Link
Redfors B, Kosmidou I, Stone GW et al. Keywords: Anterior STEMI; Infarct size; QRS fragmentation
BACKGROUND - QRS fragmentation (fQRS) is believed to reflect myocardial scar formation in patients with coronary disease. Whether early formation of fQRS in patients with ST-segment elevation myocardial infarction(STEMI) treated with percutaneous coronary intervention (PCI) is correlated with infarct size and prognosis is unknown. We assessed the prognostic value of fQRS at 60min post-PCI and its correlation with infarct size in patients with anterior STEMI managed with primary PCI.
METHODS - The INFUSE-AMI trial enrolled 452 patients with anterior STEMI undergoing primary PCI. Electrocardiograms (ECGs) were performed at baseline and 60min post-PCI. Infarct size was evaluated using cardiac magnetic resonance imaging at 30days post-PCI. Target vessel failure (TVF) was defined as the composite of cardiac death, target vessel myocardial infarction, or ischemia-driven target vessel revascularization. Study groups were defined as patients with versus without fQRS at 60min post-PCI.
RESULTS - Out of 421 patients with ECG data 60min post-PCI, 68 patients (16.2%) had fQRS. Patients with versus without fQRS had similar baseline characteristics and infarct size (16.9%±8.7% vs. 16.1%±10.5%, p=0.62), but patients with fQRS had higher adjusted risk of 1-year TVF (adjusted HR 2.27, 95% CI 1.06-4.89, p=0.036) and a trend toward a higher risk of the composite cardiac death or target vessel myocardial infarction(9.0% vs. 4.1%, p=0.08) at 1 year.
CONCLUSION - fQRS in patients with STEMI is associated with TVF but does not correlate with infarct size.
Copyright © 2017 Elsevier B.V. All rights reserved.
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