Fragmented QRS as a Predictor of Cardiovascular Events in Patients with Type 2 Diabetes Mellitus: A 36-Month Follow-Up Data

Background: Major cardiovascular events (MACE) are more common in type 2 diabetes mellitus (T2DM) patients, and early diagnosis can prevent significant morbidity and mortality. The aim of this study was to investigate the predictiveness of fragmented QRS (fQRS) showing MACE in T2DM patients.

Methods: A total of 227 T2DM patients (mean age 52, 51% male) without any cardiovascular disease who came to the cardiology outpatient clinic between March 01 and July 31, 2019, were included in the study. The patients were divided into 2 groups according to fQRS on electrocardiography (ECG), and 36 months of follow-up was done. The development of acute coronary syndrome, coronary revascularization, and cerebrovascular accident were accepted as MACE.

Results: More MACE was seen in the group with fQRS on ECG (P =.026). Although there
were more fQRS in patients with proteinuria, it was not statistically significant (P =.069). More myocardial infarcts (7.9%) and more cerebrovascular events (6.3%) were seen in the group with fQRS. While revascularization was performed on 3 patients in the fQRS group, revascularization was not performed on the patients in the non-fqrs group. In multiple
Cox regression analysis, fQRS showed an independent predictor of MACE [P =.025, hazard ratio = 2.42 (1.117-5.221)], more MACE was seen in the fQRS (+) group in the kaplan-meier analysis (P =.022).

Conclusion: More MACE was seen in the fQRS group in T2DM patients without a previous history of cardiovascular events. Fragmented QRS was found to be an independent predictor in showing MACE. Care should be taken in terms of MACE development in T2DM patients with fQRS.