Fragmented QRS predicts reperfusion failure and in-hospital mortality in ST-Elevation myocardial infarction: a systematic review and meta-analysis

AbstractObjective: Recent studies have shown that fragmented QRS (fQRS) is associated with unfavourable outcomes in STEMI patients. However, there is controversy amongst studies. We performed a systematic review and meta-analysis to explore the effect of fQRS on reperfusion failure and in-hospital mortality among this population.Methods: We searched the databases of MEDLINE and EMBASE from inception to October 2018. Included studies were published cohort studies of STEMI patients that underwent primary percutaneous coronary intervention (pPCI) and thrombolysis. Data from each study were combined using the random-effects model.Results: Ten studies from January 2011 to October 2018 (2753 patients, 1075 patients with fQRS), were included. The fQRS was associated with higher risk of reperfusion failure in pPCI when defined by ST-segment resolution (OR = 3.08, 95% CI = 1.27–7.46, p-value = .013) but not when defined by TIMI flow grade (pooled OR = 1.45, 95% CI = 0.83–2.54, p-value = .192). In thrombolysis, fQR...