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Left ventricular ejection fraction and mortality in patients with ST-elevation myocardial infarction and bundle

M Yldau van der Ende1, Minke H T Hartman, Tom Hendriks

  • 1Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Coronary Artery Disease
|December 2, 2016
PubMed

Insights

Bundle branch block (BBB) independently predicts reduced left ventricular ejection fraction (LVEF) in ST-elevation myocardial infarction (STEMI) patients. However, BBB did not impact 2-year mortality in the current era of reperfusion therapy.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • Bundle branch block (BBB) is a known complication of ST-elevation myocardial infarction (STEMI).
  • The impact of BBB on outcomes in STEMI patients treated with modern reperfusion therapies remains an area of investigation.

Purpose of the Study:

  • To evaluate the effect of BBB on mortality and left ventricular ejection fraction (LVEF) in STEMI patients receiving percutaneous reperfusion therapy.
  • To determine if BBB is an independent predictor of adverse outcomes in this patient population.

Main Methods:

  • Retrospective cohort study of 1123 STEMI patients treated between January 2011 and May 2013.
  • Follow-up duration of 2-4 years with transthoracic echocardiography performed within 2 weeks post-STEMI.

Main Results:

  • 2.0% of patients presented with left BBB and 4.4% with right BBB.
  • Two-year mortality was 25.0% in patients with BBB versus 9.2% in those without (P<0.001).
  • BBB was associated with a higher incidence of severely reduced LVEF (<30%) and lower incidence of normal LVEF.

Conclusions:

  • Bundle branch block is an independent predictor of reduced LVEF in STEMI patients.
  • BBB did not emerge as an independent predictor of 2-year mortality in the current era of percutaneous reperfusion therapy.
Abstract

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