Right bundle-branch block in anterior acute myocardial infarction in the coronary intervention era: acute angiographic findings and prognosis.
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.
Kurisu
Satoshi
S
Department of Cardiology, Hiroshima City Hospital, 7-33, Moto-machi, Naka-ku, Hiroshima, 730-8518 Japan. skurisu@nifty.com
Inoue
Ichiro
I
Kawagoe
Takuji
T
Ishihara
Masaharu
M
Shimatani
Yuji
Y
Hata
Takaki
T
Nakama
Yasuharu
Y
Kijima
Yasufumi
Y
Kagawa
Eisuke
E
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