The Relationship between Fragmented QRS and Myocardial Injury in Patients with Acute Carbon Monoxide Poisoning

• Published in: Medicina (Kaunas, Lithuania) Vol. 60; no. 6; p. 891
• Main Authors: Küçükkelepçe, Osman, Yılmaz, Emre, Çamcı, Sencer
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 28.05.2024; MDPI
• Subjects: Adult; Aged; Archives & records; Biochemistry; Biomarkers; Carbon monoxide; Carbon monoxide poisoning; Carbon Monoxide Poisoning - complications; Carbon Monoxide Poisoning - physiopathology; Carboxyhemoglobin - analysis; Cardiovascular disease; Care and treatment; Combustion; Coronary vessels; Electrocardiography; Electrocardiography - methods; Emergency medical care; Female; fragmented QRS; Humans; Hypertension; Intoxication; Male; Middle Aged; Morbidity; Mortality; myocardial injury; Natriuretic Peptide, Brain - analysis; Natriuretic Peptide, Brain - blood; Patients; Retrospective Studies; Risk Factors; Troponin - analysis; Troponin - blood; United States > US; carbon monoxide poisoning; myocardial injury; electrocardiography; fragmented QRS
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60060891

Carbon monoxide (CO) intoxication is one of the most common causes of poisoning-related deaths and complications. Myocardial injury is an important complication of CO poisoning. In our study, we aimed to evaluate the relationship between the presence and prevalence of fragmented QRS (fQRS) and myocardial injury in patients with CO intoxication. We retrospectively evaluated patients who presented to the emergency department of our tertiary care center with CO intoxication between January 2020 and December 2023. In our study, we performed subgroup analyses according to the presence of myocardial injury and fQRS. We evaluated the parameters and risk factors associated with myocardial injury. Myocardial injury was detected in 44 patients, and fQRS was detected in 38 patients. In the myocardial injury (+) group, the fQRS rate was 38.6%, and the median number of leads with fQRS was 3 (2-6) and was significantly higher than in the myocardial injury (-) group ( < 0.001). We found that carboxyhemoglobin had a significant positive correlation with troponin ( = 0.001) and pro-B-type natriuretic peptide (proBNP) ( = 0.009). As a result of multivariate analysis, we determined that age, creatinine, proBNP, fQRS, and ≥3 leads with fQRS are independent risk factors for myocardial injury. Myocardial injury in CO intoxication patients is associated with proBNP, the presence of fQRS, and the number of leads with fQRS. Age, creatinine level, proBNP, the presence of fQRS, and ≥3 leads with fQRS are independent risk factors for myocardial injury in patients with CO intoxication.