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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

Keywords: acute coronary syndrome, st elevation myocardial infarction, bundle branch block, right bundle branch block, mortality, mexico.

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Abstract:

objective: compare in-hospital outcome in patients with st-elevation myocardial infarction with right versus left bundle branch block. methods: renasica ii, a national mexican registry enrolled 8098 patients with final diagnosis of acute coronary syndrome secondary to ischemic heart disease. in 4555 stemi patients, 545 had bundle branch block, 318 (58.3%) with right and 225 patients with left (41.6%). both groups were compared in terms of in-hospital outcome through major cardiovascular adverse events; (cardiovascular death, recurrent ischemia and reinfarction). multivariable analysis was performed to identify in-hospital mortality risk among right and left bundle branch block patients. results: there were not statistical differences in both groups regarding baseline characteristics, time of ischemia, myocardial infarction location, ventricular dysfunction and reperfusion strategies. in-hospital outcome in bundle branch block group was characterized by a high incidence of major cardiovascular adverse events with a trend to higher mortality in patients with right bundle branch block (or 1.70, ci 1.19 - 2.42, p < 0.003), compared to left bundle branch block patients. conclusion: in this sub-study right bundle branch block accompanying st-elevation myocardial infarction of any location at emergency room presentation was an independent predictor of high in-hospital mortality.

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