QRS COMPLEX FRAGMENTATION AS A PREDICTOR OF MORTALITY AND REHOSPITALISATION IN THE FIRST 6 MONTHS IN ACUTE CORONARY SYNDROME IN HAJI ADAM MALIK GENERAL HOSPITAL, MEDAN

Abstract

Background: QRS fragmentation (fQRS) on the ECG is associated with partial damage to the cardiac conduction system. fQRS increases the risk of major cardiovascular events. Objective: Assessing fQRS as a predictor of mortality and rehospitalization on the first 6 months in ACS patients.

Methods: This is observational analytic study with ambispective cohort. Sampling was done consecutively from ACS patients who came to HAM Hospital starting January 2020 and followed for the next 6 months. fQRS was assessed from ECG at first admission. The prognostic performance was assessed with chi-square test and the strength of the prognostic model was assessed using AUC. Results: From 96 patients, 52 were STEMI and 44 were NSTEMI, which 36 patients (37.5%) showed fQRS. Patients with fQRS were 5,2 times to have rehospitalization (p < 0,001; 95% CI: 2,63-10,28) and 7,8 times to have mortality (p < 0.001; 95% CI: 2.39-25.22) in the first 6 months. The performance of the fQRS in predicting the incidence of rehospitalisation and 6-month mortality were 0,781 and 0,669. Conclusion: fQRS is useful as predictor of rehospitalization and mortality rate in the first 6 months for ACS patients.