Murat Cimci

Significance and Usefulness of Narrow Fragmented QRS Complex on 12-Lead Electrocardiogram in Acute ST-Segment Elevation Myocardial Infarction for Prediction of Early Mortality and Morbidity

The presence of notched R or S waves without accompanying typical bundle branch blocks, or the existence of an additional wave like RSR’ pattern in the original QRS complex (with a duration of <120 ms) has been defined as narrow QRS fragmentation. Persistence of the fQRS found on the admission electrocardiogram (ECG) in patients with acute ST segment elevation myocardial infarction (STEMI) will have prognostic significance in the short term.

Prognostic impact of diastolic blood pressure on long-term outcome in patients with non-ST-segment elevation myocardial infarction

Background: Hypertension is a well-established risk factor for cardiovascular disease, and low systolic blood pressure (SBP) is a powerful adverse prognosticator in acute coronary syndrome. We sought to investigate the relationships between diastolic blood pressure (DBP) and outcomes in patients with non-ST-segment elevation myocardial infarction (NSTE-MI). Methods: We performed a retrospective review of 122 consecutive medical records of patients (mean age: 58 10 years, 73% men) with NSTEMI who underwent coronary angiography. All patients did not have any previous cardiac events or valvular disease. Patients were classified as DBP 70 mmHg and DBP >70 mmHg. The number of diseased vessel (one vessel, two vessel and three vessel and/or left main coronary artery disease) and SYNTAX score were calculated from the angiograms to assessed the extent and severity of coronary artery disease (CAD). Two year cardiac mortality was evaluated based on medical records and telephone visits. Results: There were no significant differences between the groups in terms of age, gender, medical therapy during hospital stay and at discharge, glomerular filtration rate, and ejection fraction. As expected SBP was lower in patients with DBP 70 mmHg. The patients with DBP 70 mmHg tended to have multivessel coronary artery disease (47.5% vs 25.4%, P 1⁄4 0.009) and higher SYNTAX score (20.3 15.2 vs 14.8 70 13.6, P 1⁄4 0.037). The two year mortality rate was 10.2%. Mortality rates were not significantly different for the two groups (11.3% vs 6.5%, P 1⁄4 0.14). Conclusion: In this study, we showed that low DBP associated with severe CAD in patients with NSTE-MI. Although the mortality rate was higher in low DBP group, this difference did not reach statistical significance as the power of the study was possibly too small to reach significance.