Younis, A. S., M. I. El-Halag, M. A. ElBadry, and N. I. M. Abbas, "Fragmented QRS complex frequency and location as predictor of cardiogenic shock and mortality following acute coronary syndrome.", The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, vol. 72, issue 1, pp. 43, 2020. Abstract

BACKGROUND: Worldwide, coronary heart disease (CHD) is topping the foremost important chief causes of mortality. Fragmented QRS (f-QRS) is a pattern of QRS complex in 12 leads surface ECG which showed a promising value in predicting the outcome in cardiac diseases including ischemic heart disease. We aimed to research the importance of using f-QRS as a non-invasive and cheap tool for the prediction of cardiogenic shock and mortality in acute coronary syndrome (ACS).

METHODS: A retrospective study includes eighty four critically ill ACS patients. Patients were classified consistent with the presence or absence of fragmented QRS into two groups (46 and 38 patients respectively). Exclusion criteria include past history of important ischemic events (MI, PCI, and CABG), permanent AF, and/or cardiomyopathy. No statistical significant differences were detected between the 2 groups as regards the age, gender, major risk factors of ischemic heart condition, cardiac bio-markers, Killip class, LVEF, updated GRACE risk score of ACS, and in-hospital mortality.

RESULTS: A number value of f-QRS leads > 3 yields sensitivity and specificity (83.3% and 72.5% respectively) for predicting hospital mortality. The f-QRS group was further split-up according to the numbers of f-QRS leads into 2 subgroups; subgroup (A1) including patients with > 3 f-QRS leads and subgroup (A2) including patients ≤ 3 f-QRS leads. Subgroup (A2) showed considerable difference as regards some important variables including a higher SBP (P = 0.016), a slower HR (P = 0.014), a lower up-dated GRACE risk score (3.22 ± 6.95 vs 6.81 ± 12, P value 0.048), and a lower rate of hospital death (1/30 vs. 5/16, P = 0.015). Anterior f-QRS showed statistically significant higher HR, lower SBP, a higher frequency of shock, a higher updated GRACE risk score, and a higher chance of in-hospital mortality (P = 0.004) compared to non-anterior f-QRS.

CONCLUSION: The position and number of f-QRS leads provide a non-invasive and a readily accessible tool to predict the prognosis, occurrence of cardiogenic shock, and in-hospital mortality.

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Zaid, I. I., N. O. R. A. I. ABBAS, E. Shaker, and F. Abd-Allah, "Multiple Major Thrombo-Embolic Events, including Stroke, in a Patient with Combined Congenital Anti-Thrombin III Deficiency and MTHFR Homozygous Mutation", World Journal of Cardiovascular Diseases , vol. 7, issue 3, pp. 71-78, 2017.
Ibrahim, G. H., D. M. Ragab, A. F. Rizk, N. I. Abbas, and T. I. Hagag, "Serial heparin-binding protein compared with sequential organ failure assessment, acute physiological and chronic health evaluation ii, multiple organ dysfunction and charlson scores as predictors of mortality in critically ill septic patients", Research and Opinion in Anesthesia and Intensive Care, vol. 4, issue 3, pp. 99-107, 2017.
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Abdulfatah, M. F., N. Ismail, M. Hamdi, and R. El-Sherif, "Automatic Tube Compensation(ATC) Versus Pressure Support Ventilation (PSV) During Weaning From Mechanical Ventilation", EJICT, vol. 5, issue (1) March, pp. 21-27, 2015.
BENIAMEN, M. O. N. G. Y. H., N. O. R. A. I. ABBAS, K. A. R. I. M. S. MASHHOUR, and T. A. R. E. K. S. EL-GOHARY, "Predictors of Mortality among Head Trauma Patients Reaching the ICU Alive ", Med. J. Cairo Univ., vol. Vol. 83, issue No. 2, September, pp. 191-198, 2015.
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