Risk Factors for QRS-Fragmentation in Patients with STEMI Undergoing PCI

Tinhofer, Florian; Rakhimova, Rosana; Badykova, Elena A.; Fiedler, Lukas; Semo, Dilvin; Kaufmann, Christoph C.; Lakman, Irina A.; Agletdinov, Eduard F.; Grishaev, Dimitry M.; Cheremisina, Ksenia A.; Baraboshkina, Anastasia V.; Motloch, Lukas J.; Pistulli, Rudin; Zagidullin, Naufal S.

doi:10.3390/medicina61112023

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Open AccessArticle

Risk Factors for QRS-Fragmentation in Patients with STEMI Undergoing PCI

by

Florian Tinhofer

^1,2,3,

Rosana Rakhimova

⁴,

Elena A. Badykova

⁴

,

Lukas Fiedler

^3,5,6

,

Dilvin Semo

⁷

,

Christoph C. Kaufmann

¹,

Irina A. Lakman

⁸

,

Eduard F. Agletdinov

⁹,

Dimitry M. Grishaev

⁹

,

Ksenia A. Cheremisina

⁹,

Anastasia V. Baraboshkina

⁹

,

Lukas J. Motloch

^3,10,11,

Rudin Pistulli

^7,12,*,† and

Naufal S. Zagidullin

^4,*,†

¹

3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, 1160 Vienna, Austria

²

Medical School, Sigmund Freud University, 1020 Vienna, Austria

³

Medical School, Paracelsus Medical University, Freudplatz 1, 1020 Wien, Austria

⁴

Department of Internal Diseases, Bashkir State Medical University, Lenin str., 3, 450008 Ufa, Russia

⁵

Department of Internal Medicine, Cardiology and Nephrology, Landesklinikum Wiener Neustadt, 2700 Wiener Neustadt, Austria

⁶

Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, 3500 Krems, Austria

⁷

Department of Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, 48149 Muenster, Germany

⁸

Institute of Economics, Finance and Business, Ufa University of Science and Technology, Validy Str. 32, 450076 Ufa, Russia

⁹

«Vector-Best» RIDT JSC, 630117 Novosibirsk, Russia

¹⁰

Department of Internal Medicine II, Salzkammergut Klinikum, OÖG, 4840 Vöcklabruck, Austria

¹¹

Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University, 4020 Linz, Austria

¹²

Department of Internal Medicine I, Marien Hospital Papenburg Aschendorf, 26871 Papenburg, Germany

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^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Medicina 2025, 61(11), 2023; https://doi.org/10.3390/medicina61112023 (registering DOI)

Submission received: 21 August 2025 / Revised: 27 October 2025 / Accepted: 7 November 2025 / Published: 12 November 2025

(This article belongs to the Section Cardiology)

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Abstract

Background and Objectives: Despite modern therapy algorithms, ST-elevation myocardial infarction (STEMI) substantially contributes to cardiovascular morbidity and mortality worldwide. Early Risk assessment is crucial to guide therapy allocation, especially in countries with limited healthcare resources. Electrocardiographic parameters such as QRS fragmentation (fQRS) evolved as an important prognostic marker. The underlying mechanisms and specific risk factors for the occurrence of fQRS in patients with STEMI undergoing PCI have not been analyzed yet. Materials and Methods: Between 09/2020 and 06/2021, out of 179 consecutive patients with STEMI undergoing primary percutaneous coronary intervention (pPCI), 122 patients were included in this study. The occurrence of fQRS was analyzed and correlated to clinical as well as biochemical parameters. Results: In this population, the fQRS pattern was present in 33.6% (n = 41) of patients. Besides gender, no statistically significant differences in baseline characteristics or comorbidities were observed between the two groups. In univariable logistic regression analysis, both glomerular filtration rate (GFR) (p = 0.050) and C-reactive protein (CRP) (p = 0.014) were significantly associated with the presence of fQRS. However, in the multivariable logistic regression model, only CRP levels on admission remained independently associated with fQRS (OR = 3.44, 95% CI: 1.95; 6.05), (p = 0.029). Conclusions: In this analysis, a correlation between fQRS and CRP levels in patients with STEMI undergoing pPCI could be demonstrated. Consequently, fQRS might serve as a marker for extensive inflammation in the context of myocardial ischemia.

Keywords: fragmented QRS; STEMI; ACS; ECG

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MDPI and ACS Style

Tinhofer, F.; Rakhimova, R.; Badykova, E.A.; Fiedler, L.; Semo, D.; Kaufmann, C.C.; Lakman, I.A.; Agletdinov, E.F.; Grishaev, D.M.; Cheremisina, K.A.; et al. Risk Factors for QRS-Fragmentation in Patients with STEMI Undergoing PCI. Medicina 2025, 61, 2023. https://doi.org/10.3390/medicina61112023

AMA Style

Tinhofer F, Rakhimova R, Badykova EA, Fiedler L, Semo D, Kaufmann CC, Lakman IA, Agletdinov EF, Grishaev DM, Cheremisina KA, et al. Risk Factors for QRS-Fragmentation in Patients with STEMI Undergoing PCI. Medicina. 2025; 61(11):2023. https://doi.org/10.3390/medicina61112023

Chicago/Turabian Style

Tinhofer, Florian, Rosana Rakhimova, Elena A. Badykova, Lukas Fiedler, Dilvin Semo, Christoph C. Kaufmann, Irina A. Lakman, Eduard F. Agletdinov, Dimitry M. Grishaev, Ksenia A. Cheremisina, and et al. 2025. "Risk Factors for QRS-Fragmentation in Patients with STEMI Undergoing PCI" Medicina 61, no. 11: 2023. https://doi.org/10.3390/medicina61112023

APA Style

Tinhofer, F., Rakhimova, R., Badykova, E. A., Fiedler, L., Semo, D., Kaufmann, C. C., Lakman, I. A., Agletdinov, E. F., Grishaev, D. M., Cheremisina, K. A., Baraboshkina, A. V., Motloch, L. J., Pistulli, R., & Zagidullin, N. S. (2025). Risk Factors for QRS-Fragmentation in Patients with STEMI Undergoing PCI. Medicina, 61(11), 2023. https://doi.org/10.3390/medicina61112023

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Risk Factors for QRS-Fragmentation in Patients with STEMI Undergoing PCI

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