İlhan Koyuncu1, Mehmet Eyüboğlu2

1Uşak University School of Medicine, Department of Cardiology, Uşak, Turkey
2Gaziosmanpaşa University School of Medicine, Department of Cardiology, Tokat, Turkey

Keywords: Fragmented QRS; inflammation; acute myocardial infarction; monocyte count


Introduction: Inflammation plays a crucial role in the pathophysiology of acute myocardial infarction (AMI). Recent data suggest that some inflammatory markers may predict presence of fragmented QRS (fQRS) on electrocardiography (ECG) in AMI patients. However, data regarding which inflammatory marker predicts the presence of fQRS more accurately remains unclear. In this study, we aimed to define the strongest predictor of the presence of fQRS on EGC among various hematological inflammatory markers in patients presenting with AMI.

Patients and Methods: A total of 906 patients with AMI were included into the study. The association between fQRS and various hematological inflammatory markers such as white blood cell (WBC) count, monocyte count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte to highdensity lipoprotein ratio (MHR) were investigated.

Results: The frequency of fQRS was found to be 44.4% in the study population. Patients with fQRS had significantly higher values of WBC, MHR, neutrophil and monocyte counts compared to those without fQRS. The value of NLR and PLR were similar in patients with and without fQRS. In the Receiver operating characteristics (ROC) curves analyses, a monocyte count > 0.79 (×103/μL) was found to be a predictor of presence of fQRS on ECG with a specificity of 80.36% and a sensitivity of 60.95% (AUC: 0.754, p< 0.001). Furthermore, multivariate analysis demonstrated that only monocyte count was an independent predictor of fQRS among all hematological inflammatory markers (p< 0.001, odds ratio:1.221, 95% confidence interval:1.078-1.447).

Conclusion: Monocyte count is the strongest predictor of fQRS among all hematological inflammatory markers and may be useful in risk stratification of patients with AMI.

Cite this article as: Koyuncu İ, Eyüboğlu M. Hematological inflammatory markers and fragmented QRS complexes in patients presenting with acute myocardial infarction. Koşuyolu Heart J 2020;23(3):169- 75.