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

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.