The Relationship Between fragmented QRS Complexes (fQRS) and the Severity of Coronary Artery Lesion in Coronary Artery Disease: A Cross-sectional Study

Abstract

Background: The severity of coronary artery lesion is commonly used as a predictor of mortality, major adverse cardiovascular event (MACE), and revascularization in coronary artery disease (CAD). Fragmented QRS complex (fQRS) is used as a marker of myocardial ischemia in patients with CAD. The relationship between the two should be studied further. The objective of this study was to determine the relationship between fQRS and the severity of coronary lesion in patients with CAD. Methods: A cross-sectional study was conducted at Cipto Mangunkusumo Hospital Jakarta. Secondary data were taken from 172 patients with CAD who underwent percutaneous coronary intervention (PCI) from January to June 2018 with total sampling. Patients were divided into two groups based on the existence of fQRS. Demographic, clinical, and corangiography characteristics (Gensini score, total vascular lesion, and vascular lesion significance) were studied. Data were analyzed using agreement test and chi-square. Results: fQRS was present in 94 subjects (54.6%). Bivariate analysis showed a significant difference between fQRS with mild-moderate Gensini score as well as mild-severe Gensini score (kappa = 0.721 and 0.820; p<0.001), fQRS with significant CAD (kappa = 0.670; p<0.001), and fQRS with multivessel CAD (kappa = 0.787; p<0.001). Conclusion: There is a significant relationship between fQRS and the degree of severity of coronary lesion in CAD patients. Keywords: coronary artery disease, fragmented QRS, Gensini score