[Prognostic significance of acute bundle branch block in patients with acute myocardial infarction].
OBJECTIVE
Acute bundle branch block (ABBB) presence is associated with the increasing mortality of patients with acute myocardial infarction (AMI). The aim of this study was investigate ABBB influence with respect to in-hospital (IN) and long-term mortality in patients with AIM, as well as total mortality in follow-up, the presence of in-hospital congestive cardiac insufficiency (CCI) and the presence of CCI at follow-up.


METHODS
This study included 606 consecutive patients with AMI. A total of 415 (68.5%) were males and 191 (31.5%) females, mean age 64.0 +/- 11.9. After the dismissal the patients underwent 18-month follow-up period.


RESULTS
Acute bundle branch block was registered in 44 patients (7.2%), out of which 15 patients (2.4%) had the left (L) ABBB and 29 patients (4.8%) had the right (R) ABBB. The patients with ABBB showed higher proportion of IH CCI (Killip III and IV) and hypotension compared with the control group (patients without ABBB). In the group of patients with ABBB beta-blockers, statins, aspirin and ACE-inhibitors were less applied. All the three ABBB groups exhibited an increased IH mortality (ABBB 47.7% vs 11.2%, p < 0.01, ARBBB 55.1% vs 11.2% p < 0.01, ALBBB 33.3% vs 11.2%, p < 0.01). Follow-up mortality of the patients with ABBB and ALBBB was higher in comparison with the control group (log-rank p = 0.046 and log-rank p = 0.01, respectively), whereas the group with ARBBB did not show any differences (log-rank, p = 0.59).


CONCLUSIONS
The patients with ABBB AMI are a risk group of patients that commonly exhibit both early and remote CCI accompanied by high mortality. That is the reason why this sub-group of AMI patients should receive an urgent diagnostics followed by aggressive therapeutic treatment.
Mijailović
Vuk
V
Opsta bolnica Uzice, Uzice, Beograd. vuk.mijailovic@yahoo.com
Mrdović
Igor
I
Ilić
Marina
M
Asanin
Milika
M
Srdić
Milena
M
Rajić
Dubravka
D
D000368:Aged; D002037:Bundle-Branch Block / Q000150:complications*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D011379:Prognosis