Impact of new-onset right bundle branch block on long-term clinical outcomes in acute myocardial infarction
J G Lee, S Y Choi, K Y Boo, J H Choi, S Y Kim, S G Kim, Y K AhnAbstract
Background and purposes
The prognostic implications of new-onset right bundle branch block (RBBB) in patients with acute myocardial infarction (AMI) remain uncertain. This study was designed to evaluate the association between new-onset RBBB and clinical outcomes in patients presenting with AMI.
Methods
Of 15,628 AMI patients enrolled in the nationwide KAMIR-V registry, we evaluated 11,862 patients who survived the index event after successful drug-eluting stent implantation; 506 exhibited new-onset RBBB on the admission electrocardiogram. Primary outcome was a composite of cardiac death, recurrent MI, and hospitalization for heart failure (HF).
Results
The mean age was 63.4 years, 79% of the patients were men, and 50% had STEMI. Over a 3-year follow-up period, the incidence of primary outcomes in AMI patients with new-onset RBBB was higher compared with those without RBBB. This difference was primarily driven by a significantly increased rate of hospitalization for heart failure in the new-onset RBBB group. In contrast, rates of cardiac death, recurrent MI, all-cause death, any revascularization, and stent thrombosis did not differ significantly between groups.
Conclusions
New-onset RBBB in AMI patients was associated with adverse long-term clinical outcomes. These findings suggest that the presence of new-onset RBBB may identify a high-risk subgroup requiring closer surveillance and intensified management.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.