Background: Fragmented QRS (fQRS) is a reliable predictor of a negative outcome for patients, particularly when it occurs alongside ST-segment elevation myocardial infarction (STEMI).Aim of study: To assess the clinical significance and prognostic value of fQRS for patients who are presenting with acute myocardial infarction.Patients and methods: This study is a prospective study which included seventy patients(48 males and 22 females, their mean age was 54.9±9 years) which is carried out in Coronary Care Unit (CCU) at Azadi Teaching Hospital in Kirkuk            from the period 15th of May to 15th of December 2018. After the diagnosis of acute STEMI with fQRS, our patients were received full medical therapy then followed up in the CCU for an average of 3 days.Results: The arrhythmia was detected among 34.3% of STEMI patients with fQRS and hypotension was present among 20% of them. Low ejection fraction was found in 77.1% of patients and death was recorded for 11.4% of them. Low ejection fraction of STEMI patients with fQRS were significantly related to older age, males, long pre-hospital symptoms duration, diabetes, hypertension and previous history of ischemic heart diseases.Conclusions: The fQRS in acute ST elevation myocardial infarction is predictor for adverse cardiac outcomes and mortality.

 Background: The term ischemic heart disease (IHD) reflects a spectrum of coronary atherosclerosis which includes  obstructive coronary artery disease, dysfunction of the coronary microvasculature and endothelium, and plaque erosion/distal microembolization. Objective : To determine the clinical profile, coronary angiographic profile, and short-term outcome of IHD in women. Methodology: A prospective multicenter hospital-based registry of cardiovascular disease in women conducted in cardiac centers in three cities (Baghdad, Basra, and Duhok). The target population of this study was woman patient aged 18 years or older, who admitted with the diagnosis of  acute coronary system (ACS) or who suspected to have chronic coronary syndrome (CCS) and referred for coronary angiography. Results:  The total number of patients included in the study was 123 women with mean age 60 ± 9.8 years. There were a significant association between development of IHD and old age, diabetes mellitus, menopause, and family history of IHD. Among the total number of patients who underwent coronary catheterization, 24 (25%) had normal coronaries. One-month re-hospitalization for new cardiac events was 12 (12.8%). The total number of mortalities in the current study was 6 (5%) patients, all of them were diagnosed as ACS, among them 4 (67%) patients died during index hospitalization and 2 (33%) patients died throughout one month follow up. Conclusions : The current study identified the most significant contributing factors for development of IHD in women were old age, diabetes, menopause, and family history of IHD. About one- quarter of patients who were diagnosed with IHD had developed heart failure with reduced ejection fraction . Moreover, about one-quarter of patients who underwent coronary catheterization had normal coronaries. Among patients with ACS, coronary catheterization was done in only one-fifth of the patients. Finally, Two-thirds of total mortality occurred during baseline hospitalization while one- third occurred throughout one month follow up period.