Impact of Bundle Branch Block on Long-term Prognosis in Patients With Acute Coronary Syndrome After Percutaneous Coronary Intervention / 中国循环杂志

ABSTRACT

Objective: To explore the impact of bundle branch block (BBB) on acute coronary syndrome (ACS) prognosis in patients after percutaneous coronary intervention (PCI). Methods: A total of 6 429 ACS patients received PCI in our hospital from 2013-01 to 2013-12 were enrolled. According to BBB diagnosis at discharge, the patients were divided into 2 groups: BBB group, n=159 and Non-BBB group, n=6 270. The incidences of 2-year major adverse cardio and cerebral-vascular events (MACCE) including all-cause death, cardiac death, myocardial infarction, revascularization, in-stent thrombosis and stroke were compared between 2 groups; relationship between existing BBB and clinical outcomes was assessed. Results: Compared with Non-BBB group, BBB group had the elder age (62.97±11.37) years vs (58.26±10.36) years, lower BMI (25.31±3.02) vs (25.89±3.20), decreased glomerular filtration rate (86.89±16.15)ml/min vs (91.05±15.53)ml/min and LVEF (59.27±9.86)% vs (62.37±7.36) %, all P<0.05; other baseline condition, angiographic and interventional features were similar between 2 groups, all P>0.05. During 2-year follow-up period, compared with Non-BBB group, BBB group showed the higher incidences of cardiac death (2.5% vs 0.7%) and in-stent thrombosis (3.1% vs 0.8%), both P<0.05; other incidences of MACCE were similar between 2 groups, all P>0.05. With adjusted propensity score matching, 2-year incidence of MACCE was similar between 2 groups, P>0.05; 2-year incidences of MACCE in BBB group including LBBB and RBBB were similar to Non-BBB group, P>0.05. Cox regression analysis revealed that BBB was not related to ACS prognosis after PCI. Conclusion: BBB was not an independent risk factor for long-term MACCE occurrence in ACS patients after PCI.