Author + information
- Ajay Agarwala,b,
- Amish Patela,b,
- Jonathan Pollocka,b,
- Samuel Robertoa,b,
- Thein Aunga,b and
- Ronald Markerta,b
Background: The evidence for left bundle branch block (LBBB) or right bundle branch block (RBBB) being a better predictor of mortality is inconsistent. A retrospective analysis was conducted to determine if BBB is an independent risk factor for mortality in a cohort of U.S. Veterans with atherothrombotic risk factors.
Methods: Data from a Veterans Affairs (VA) health care facility were retrospectively collected for n=1193 consecutive patients (October 2001 to January 2005) to determine long term mortality rates in patients with and without BBB who presented for coronary angiography.
Results: With a mean follow up of 103±52 months, patients with BBB accounted for 11.4% (136/1193) of this cohort. Mean age was 68.9±9.6 years with 95% male. Mean body mass index (BMI) was 29.2±4.9. The prevalence of selected risk factors was: hypertension (95%), coronary artery disease (94%), hyperlipidemia (77%), diabetes (55%), left ventricular hypertrophy (49%), history of peripheral vascular disease (19%), and history of cerebrovascular accident (9%). The baseline serum creatinine was 1.9±1.3 mg/dL, with 18% patients having chronic kidney disease. Mean left ventricular ejection fraction (LVEF) was 40±16%, and mean QRS duration was 143.7±20.9 milliseconds. LBBB and RBBB were reported in 54 (39.7%) and 82 (60.3%) of the 136 patients with BBB, respectively. The mortality rate was higher in patients with BBB vs. no BBB (74.3% vs. 45.4%, p<0.001) and those with LBBB vs. RBBB (85.2% vs. 67.1%, p=0.018). The odds of mortality were higher for those with BBB compared to those without BBB (unadjusted odds ratio [OR] = 3.47 [95% Cl=2.32 to 5.20]). The odds of mortality remained higher for the BBB group after adjusting for the 12 significant univariate risk factors list above (adjusted OR = 3.06 [95% Cl=1.22 to 7.86], p=0.01).
Conclusions: In this retrospective study of US Veterans with atherothrombotic risk factors, the all-cause mortality rate was higher with BBB and even greater for LBBB than RBBB. We concluded BBB was an independent risk factor for mortality within this specific cohort.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-345
- 2017 American College of Cardiology Foundation