Abstract: AIM:To investigate the predictive value of fragmented QRS wave in the resting 12-lead ECG for 1-year prognosis of patients with ST segment elevation acute myocardial infarction (STEMI). METHODS: One hundred and fifty-four patients with acute STEMI were divided into non-fQRS group and fQRS group and all patients were followed up for 1 year. Baseline data, risk factors, coronary angiography, left ventricular ejection fraction (LVEF), incidences of ventricular wall motion abnormality and malignant arrhythmia, and all-cause mortality were compared among groups. RESULTS: No significant difference was observed among groups in baseline data and three major cardiovascular risk factors. The cTnI value in fQRS group was higher than in non-fQRS group. In fQRS group, the proportion of double vessel lesion was smaller, whereas the three-vessel lesion proportion was greater. During the period of hospitalization, fQRS group had higher mortality and higher proportion of low LVEF (<50%) than non-fQRS group. During a 1-year follow-up, fQRS group had higher mortality, more malignant arrhythmia and larger proportion of low LVEF (<50%) than non-fQRS group. No significant difference was found in mortality rate and low LVEF (<50%) proportion between the 1-year follow-up and the period of hospitalization in non-fQRS group, whereas the incidences of ventricular tachycardia and ventricular wall motion abnormality were significantly decreased. In fQRS group, mortality rate was higher during 1-year follow-up. No significant difference was seen in other indexes in fQRS group. CONCLUSION: fQRS is of some predictive value for the 1-year prognosis of patients with STEMI.