Association of Mortality in Patients with Right Bundle Branch Block in Patients Presented withAnterior Wall Myocardial Infarction during Hospital Stay
Abstract
To determine the association of mortality with right bundle branch block in individuals presenting with acute anterior wall myocardial infarction during hospital stay.
This Cohort study was done in Department of Cardiology, University of Lahore hospital, Lahore during September 2022 to March 2023. Sample size of 160 individuals; 80 in each group were enrolled. Then, ECG will be performed at admission and individuals were divided in two groups i.e. exposed and unexposed. During follow-up, it patient died within hospital stay, then in-hospital mortality was labeled. Data was collected in proforma and analysed in SPSS version 25.
In exposed group, the mean age of individuals was 47.51 ± 10.56 years and in unexposed group was 49.99 ± 12.82 years. In exposed group, there were 36 (45.0%) males and 44 (55.0%) females. In unexposed group, there were 33 (41.3%) males and 47 (58.8%) females. In exposed group, 17 (21.3%) individuals died during hospital stay. In unexposed group, 5 (6.3%) individuals died during hospital stay. There is significant association exist between right bundle branch block and in-hospital mortality i.e. Relative risk = 1.693, 95% confidence interval = 1.266, 2.264, p-value = 0.006).
Thus, there is a significant association of right bundle branch block with mortality in individuals with acute anterior wall STEMI.
How to Cite This Article
Kamran RMH, Ahmad W, Younis KA, Munib HM, Sajjad A, Siddique K, et al.. Association of Mortality in Patients with Right Bundle Branch Block in Patients Presented withAnterior Wall Myocardial Infarction during Hospital Stay. J Pak Soc Intern Med. 2023;4(3):218–222. doi:10.70302/jpsim.v4i3.2344
Conflict of Interest
All authors declare no competing interests.
Funding
No specific funding was received for this research.
Funder information follows the Crossref Funder Registry standard.
References
- Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2019;40(3):237-69.
- Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016;133(4):e38-360.
- Vogel B, Claessen BE, Arnold SV, Chan D, Cohen DJ, Giannitsis E, et al. ST-segment elevation myocardial infarction. Nat Rev Dis Prim. 2019;5(1):39.
- Basit H, Kahn A, Zaidi S, Chadow H, Khan A. A Case of ST-Elevation Myocardial Infarction With Right Bundle Branch Block, an Ominous Sign of Critical Coronary Occlusion. Cureus. 2022;14(1):e21216.
- Hashim M, Zeb S, Shah GA, Rizvi SNH. In-hospital mortality in patients of ST elevation MI presenting with right bundle branch block. Pak Heart J. 2017;50(4).
- Paul A, Bhatia KS, Alex AG, Thomson VS, Mani T, Sharathbabu NM. Electrocardiographic Predictors of Mortality in Acute Anterior Wall Myocardial Infarction With Right Bundle Branch Block and Right Precordial Q-Waves (qRBBB). Canad J Cardiol. 2020;36(11):1764-9.
- Trofin M, Israel CW, Barold SS. Right bundle branch block and anterior wall ST elevation myocardial infarction. Herzschrittmachertherapie Elektrophysiol. 2017;28(3):340-3.
- Xiang L, Zhong A, You T, Chen J, Xu W, Shi M. Prognostic Significance of Right Bundle Branch Block for Patients with Acute Myocardial Infarction: A Systematic Review and Meta-Analysis. Medical science monitor : Int Med J Experi Clin Res. 2016;22(6):998-1004.
- Elsayed YMH. Acute myocardial infarction associated with right bundle branch block and changeable trifascicular block: a case report. J Acute Dis. 2019;8(5):215.
- Mishra V, Sinha SK, Razi M. Right Bundle Branch Block: A Masquerader in Acute Coronary Syndrome. North Am J Med Sci. 2016;8(2):121-2.
- Neumann JT, Sörensen NA, Rübsamen N, Ojeda F, Schäfer S, Keller T, et al. Right bundle branch block in patients with suspected myocardial infarction. Eur Heart J: Acute Cardiovasc Care. 2019;8(2):161-6.
- Wong C-K, Gao W, Stewart RAH, Pelt Nv, French JK, Aylward PEG, et al. Risk Stratification of Patients With Acute Anterior Myocardial Infarction and Right Bundle-Branch Block. Circulation. 2006;114(8):783-9.
- Xiong Y, Wang L, Liu W, Hankey GJ, Xu B, Wang S. The Prognostic Significance of Right Bundle Branch Block: A Meta-analysis of Prospective Cohort Studies. Clin Cardiol. 2015;38(10):604-13.
- Juárez-Herrera Ú, Jerjes Sánchez C, González-Pacheco H, Martínez-Sánchez C. In-hospital outcome in patients with ST elevation myocardial infarction and right bundle branch block: A sub-study from RENASICA II, a national multicenter registry. Arch Cardiol México. 2010;80(3):154-8.
- da Silva F, Andrade A, dos Santos V, Margalho C. Transient right bundle-branch block in anterior descending coronary occlusion. Arch Hellenic Med/Arheia Ellenik Iatrik. 2023;40(1):123-7.
- Ardiana M, Sufiyah IM, Hamdani MN. Right bundle branch block evolving to myocardial ischemia in a patient with chronic middle back pain: a case report. J Med Case Rep. 2023;17(1):1-5.
- Shrivastav R, Pati P, Perimbeti S, Tamis-holland J. Abstract 17004: Right Bundle Branch Block (RBBB) is Associated With Poor Prognosis in Patients With Anterior Wall ST Elevation Myocardial Infarction (AWMI): A Nationwide Study Using the National Inpatient Sample (NIS). Circulation. 2018;138(S1):A17004-A.
- Hod H, Goldbourt U, Behar S, GROUP SS. Bundle branch block in acute Q wave inferior wall myocardial infarction: A high risk subgroup of inferior myocardial infarction patients. Eur Heart J. 1995;16(4):471-7.
- Wong C-K, Stewart RA, Gao W, French JK, Raffel C, White HD. Prognostic differences between different types of bundle branch block during the early phase of acute myocardial infarction: insights from the Hirulog and Early Reperfusion or Occlusion (HERO)-2 trial. Eur Heart J. 2006;27(1):21-8.
- Zameer I, Kashif M, Perveez A, Murad A, Asad M, Khan A, et al. In-Hospital Outcomes of Patients Presenting with Acute Anterior STEMI with Right Bundle Branch Block. Pak Arm Forces Med J. 2022;72(S3):S518-23.
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