Evidence map›Paper›PMID 38269630›Full record

ArticleClinical cardiology2024

QRS fragmentation does not predict mortality in survivors of acute myocardial infarction.

Julia Allescher, Daniel Sinnecker, Bernhard von Goeldel, Petra Barthel, Alexander Müller, Alexander Hapfelmeier, Eimo Martens, Karl-Ludwig Laugwitz, Georg Schmidt, Alexander Steger

Open access · goldAbstract read
In one paragraph

Article in Clinical cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Julia AllescherKlinik und Poliklinik für Innere Medizin I, University Hospital, Technical University of Munich, Munich, Germany.
Daniel SinneckerKlinik und Poliklinik für Innere Medizin I, University Hospital, Technical University of Munich, Munich, Germany.
Bernhard von GoeldelKlinik und Poliklinik für Innere Medizin I, University Hospital, Technical University of Munich, Munich, Germany.
Petra BarthelKlinik und Poliklinik für Innere Medizin I, University Hospital, Technical University of Munich, Munich, Germany.
Alexander MüllerKlinik und Poliklinik für Innere Medizin I, University Hospital, Technical University of Munich, Munich, Germany.
Alexander HapfelmeierSchool of Medicine, Institute of AI and Informatics in Medicine, Technical University of Munich, Munich, Germany.
Eimo MartensKlinik und Poliklinik für Innere Medizin I, University Hospital, Technical University of Munich, Munich, Germany.
Karl-Ludwig LaugwitzKlinik und Poliklinik für Innere Medizin I, University Hospital, Technical University of Munich, Munich, Germany.
Georg SchmidtKlinik und Poliklinik für Innere Medizin I, University Hospital, Technical University of Munich, Munich, Germany.
Alexander StegerKlinik und Poliklinik für Innere Medizin I, University Hospital, Technical University of Munich, Munich, Germany.ORCID http://orcid.org/0000-0002-0033-6941
Technical University of Munich · DEGerman Centre for Cardiovascular Research · DEMedizinisches Versorgungszentrum Prof. Mathey, Prof. Schofer · DE

Funding

Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie 13N/7073/7Deutsche Forschungsgemeinschaft SFB 386The Kommission für Klinische Forschung
6 · The paper itself

Abstract

backgroundDespite advances in coronary revascularization and in heart failure management, myocardial infarction survivors remain at substantially increased mortality risk. Precise risk assessment and risk-adapted follow-up care are crucial to improve their outcomes. Recently, the fragmented QRS complex, i.e. the presence of additional spikes within the QRS complexes on a 12-lead electrocardiogram, has been discussed as a potential non-invasive risk predictor in cardiac patients. HYPOTHESIS: The aim of this study was to evaluate the prognostic meaning of the fragmented QRS complex in myocardial infarction survivors.

methods609 patients with narrow QRS complexes <120 ms were included in a prospective cohort study while hospitalized for myocardial infarction and followed for 5 years.

resultsThe prevalence of the fragmented QRS complex in these patients amounted to 46.8% (285 patients). These patients had no increased hazard of all-cause death (HR 0.84, 95%-CI 0.45-1.57, p = 0.582) with a mortality rate of 6.0% compared to 7.1% in patients without QRS fragmentations. Furthermore, the risks of cardiac death (HR 1.28, 95%-CI 0.49-3.31, p = 0.613) and of non-cardiac death (HR 0.6, 95%-CI 0.26-1.43, p = 0.25) were not significantly different in patients with QRS fragmentations. However, patients with QRS fragmentations had increased serum creatine kinase concentrations (1438U/l vs. 1160U/l, p = 0.039) and reduced left ventricular ejection fractions (52% vs. 54%, p = 0.011).

conclusionsThe hypothesis that QRS fragmentation might be a prognostic parameter in survivors of myocardial infarction was not confirmed. But those with QRS fragmentation had larger myocardial infarctions, as measured by creatine kinase and left ventricular ejection fraction.

Indexed as

Myocardial InfarctionVentricular Function, LeftCreatine KinaseHumansProspective StudiesStroke VolumeSurvivorsCreatine Kinaseacute myocardial infarctionelectrocardiogramfragmented QRS complexmortalitynoninvasive risk stratification

Identifiers

PMID38269630
PMCPMC10797824
OpenAlexW4391026008

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.