Right bundle-branch block in anterior acute myocardial infarction in the coronary intervention era: acute angiographic findings and prognosis

Int J Cardiol. 2007 Mar 2;116(1):57-61. doi: 10.1016/j.ijcard.2006.02.010. Epub 2006 Jul 3.


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).

Methods and 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.

Publication types

  • Comparative Study

MeSH terms

  • Age Distribution
  • Aged
  • Bundle-Branch Block / diagnosis*
  • Bundle-Branch Block / epidemiology*
  • Comorbidity
  • Coronary Angiography / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Japan / epidemiology
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / therapy
  • Myocardial Reperfusion / statistics & numerical data
  • Prognosis
  • Sex Distribution
  • Survival Analysis
  • Treatment Outcome
  • Ventricular Dysfunction, Left / epidemiology