Efficacy of adjunctive treatment with trimetazidine for fragmented QRS among patients with ischemic heart failure: a propensity score match analysis

Authors : Selçuk KANAT, Barış ŞENSOY

Pages : 291-298

Doi:10.18621/eurj.397369

View : 20 | Download : 16

Publication Date : 2019-03-04

Article Type : Research Paper

Abstract :Objectives: Fragmented QRS insert ignore into journalissuearticles values(fQRS); is an indicator of nonhomogeneous ventricular activity caused by myocardial ischemia and fibrosis. The anti-ischemic agent trimetazidine insert ignore into journalissuearticles values(TMZ); added to pharmacological treatment appears to have positive effects on cardiac parameters of patients with ischemic heart failure. We aimed to investigate the relationship of fQRS with adjunctive TMZ therapy in ischemic HF patients. Methods: Four hundred eighty-nine consecutive ambulatory ischemic patients with heart failure eligible for our study were recruited for the study. A 12-lead electrocardiogram with standard chest and limb leads was used to evaluate the presence of fQRS. Further patients were divided into groups according to adjunctive TMZ treatment and fQRS presence. Confounding factors were adjusted by propensity score matching and multivariate logistic regression analysis. Results: One hundred ninety-seven insert ignore into journalissuearticles values(40.3%); patients had fQRS on their ECGs and 235 insert ignore into journalissuearticles values(48.1%); patients were on adjunctive treatment with trimetazidine. Compared to patients without fQRS, patients with fQRS had lower left ventricular ejection fraction insert ignore into journalissuearticles values(LVEF);, higher NYHA classes and more frequent mineralocorticoid receptor antagonist and diuretic usage insert ignore into journalissuearticles values( p < 0.05);. Add-on treatment with TMZ was independently associated with fQRS presence insert ignore into journalissuearticles values(OR, 0.45; insert ignore into journalissuearticles values(95% CI, 0.29-0.70);; p < 0.0001);. Conclusion: According to conventional therapy, adjunctive treatment with TMZ among ischemic heart failure patients can be associated with fQRS in 12-lead ECG independent of LVEF.
Keywords : Adjunctive treatment, fragmented QRS, ischemic heart failure, myocardial fibrosis, trimetazidine