New-onset and old RBBB or LBBB were not significantly associated with differences in the severity of coronary lesions as assessed by SYNTAX score in patients without known CAD.
Observational (n=243)
Does the subtype and timing of bundle-branch block (new vs old, RBBB vs LBBB) associate with the severity of coronary atherosclerosis in patients without known CAD?
The subtype and timing of bundle-branch block (new vs old, RBBB vs LBBB) does not appear to be associated with the angiographic severity of coronary atherosclerosis in patients without known CAD.
BACKGROUND: Right bundle-branch block (RBBB) and left bundle-branch block (LBBB) play a role in the pathogenesis and progression of coronary artery disease (CAD). However, the clinical features and the severity of coronary artery disease associated with different subtypes of bundle-branch block, according to time of new appearance, is not well characterized in patients with no known CAD. METHODS: We retrospectively analyzed data pertaining to consecutive patients with RBBB or LBBB who underwent coronary angiography. The severity of coronary lesions was evaluated using the SYNTAX score. The differential effect of new-onset RBBB, old RBBB, new-onset LBBB, and old LBBB on the severity of CAD and its association with clinical characteristics was quantified. Multivariate logistic regression analysis was performed to evaluate the effect of RBBB and LBBB on the degree of coronary atherosclerosis in patients without known CAD. RESULTS: Out of the 243 patients, 72 patients had old LBBB, 37 had new-onset LBBB, 93 patients had old RBBB, and 41 patients had new-onset RBBB. On univariate analysis, age, systolic blood pressure, diastolic blood pressure, creatinine, serum glucose, and glycosylated hemoglobin level were associated with high SYNTAX score (p < .05 for all). Patients in the new-onset RBBB, old RBBB, new-onset LBBB, and old LBBB groups showed significant differences in baseline characteristics and coronary atherosclerosis (p < .05 for all). However, there were no significant between-group differences with respect to the degree of coronary atherosclerosis as assessed by SYNTAX score. CONCLUSIONS: New-onset RBBB, old RBBB, new-onset LBBB, and old LBBB were not associated with the severity of coronary lesions as assessed by SYNTAX score in patients without known CAD.
Zhu et al. (Wed,) conducted a observational in Bundle-branch block and coronary artery disease (n=243). Subtypes of bundle-branch block (new-onset vs old RBBB/LBBB) vs. Between-group comparison was evaluated on Severity of coronary lesions assessed by SYNTAX score. New-onset and old RBBB or LBBB were not significantly associated with differences in the severity of coronary lesions as assessed by SYNTAX score in patients without known CAD.