Prognostic impact of left bundle-branch block in the early stable phase after acute myocardial infarction.

摘要

BACKGROUND: Diagnostic marker parameters are needed to enable timely identification of high risk patients after acute myocardial infarction (MI). We assessed risk factors for death and sudden death in stable revascularized patients undergoing guideline-based therapy during an in-patient rehabilitation program more than 3 weeks after acute myocardial infarction. METHODS: During an in-patient rehabilitation program, 939 patients with a recent myocardial infarction were prospectively included. Besides demographic and clinical data, ejection fraction (EF), Holter ECG, standard 12-lead electrocardiogram (ECG) and baseline laboratory values were determined. Patients were followed up for 18 months. RESULTS: Among multiple variables, left bundle-branch block (LBBB) was the most significant parameter affecting the outcome (combination endpoint of death, resuscitation or ventricular tachycardia (VT)), hazard ratio 7.74 (3.2-18.7, P<0.0001). 42% of the 24 patients with LBBB but only 11.5% of the 62 patients with a left ventricular EF