title: Right bundle-branch block in anterior acute myocardial infarction in the coronary intervention era: acute angiographic findings and prognosis.
abstract: BACKGROUND
  Previous studies in the prethrombolytic or thrombolytic era have reported that right bundle-branch block (RBBB) is associated with poor clinical outcome in patients with acute myocardial infarction (AMI).
  
  
  RESULTS
  The purpose of this study was to examine the relations between RBBB and angiographic findings or clinical outcomes in patients with AMI in the coronary intervention era. A total of 430 patients with a first anterior AMI who underwent coronary angiography within 12 h after the onset were enrolled in this study. Seventy-one patients (17%) had RBBB documented during their hospital stay. RBBB was documented on admission in 35 patients. Patients with RBBB were older (p<0.01) and had prodromal angina less frequently (p=0.03) than those without. On the initial angiograms, patients with RBBB had an occluded left anterior descending artery (p<0.01) and multivessel disease (p=0.01) more frequently than those without. Thirty-day mortality rate was significantly higher in patients with RBBB than in those without (14.0% vs 1.9%, p<0.01). Multiple logistic-regression analysis demonstrated that RBBB (odds ratio 5.89, p<0.01) and multivessel disease (odds ratio 4.36, p=0.01) were independent predictors of 30-day mortality.
  
  
  CONCLUSIONS
  Our data suggested that RBBB was still associated with poor clinical outcome in patients with anterior AMI even in the coronary intervention era.
authors.affiliation: Department of Cardiology, Hiroshima City Hospital, 7-33, Moto-machi, Naka-ku, Hiroshima, 730-8518 Japan. skurisu@nifty.com
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurisu
authors.forename: Ichiro
authors.initials: I
authors.lastname: Inoue
authors.forename: Takuji
authors.initials: T
authors.lastname: Kawagoe
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimatani
authors.forename: Takaki
authors.initials: T
authors.lastname: Hata
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakama
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Kijima
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kagawa
mesh_terms: D017677:Age Distribution; D000368:Aged; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy; D015425:Myocardial Reperfusion / Q000706:statistics & numerical data; D011379:Prognosis; D017678:Sex Distribution; D016019:Survival Analysis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology