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Association between cardiac conduction block and cardiovascular disease and all-cause mortality: The kailuan study
Xuemei Yang1, Shuohua Chen2, Haicheng Song3
1Department of Rheumatic Disease, Kailuan General Hospital, Tangshan, Hebei, China; Graduate school, North China University of Science and Technology, Tangshan, Hebei, China.
Insights
Cardiac conduction block (CCB) significantly increases the risk of cardiovascular disease (CVD) and all-cause mortality in the general population. Early prevention strategies for CCB are crucial for reducing these adverse health outcomes.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Bundle branch block and atrioventricular block are known risk factors for cardiovascular disease (CVD) and mortality.
- The specific relationship between broader cardiac conduction block (CCB) and both CVD and all-cause mortality has not been extensively explored.
Purpose of the Study:
- To investigate the association between cardiac conduction block (CCB) and the incidence of cardiovascular disease (CVD) and all-cause mortality.
- To evaluate the impact of CCB on mortality and CVD events in a large population cohort.
Main Methods:
- Utilized data from 145,805 participants in the Kailuan study, with a mean follow-up of 12.5 years.
- Cardiac conduction block (CCB) was identified using 12-lead electrocardiography (ECG).
- Mortality and CVD events were tracked through multiple comprehensive data sources.
Main Results:
- Individuals with CCB exhibited a higher cumulative incidence of CVD (18.38% vs. 12.14%) and all-cause mortality (33.45% vs. 14.18%) compared to those without CCB.
- Multivariable analysis revealed significantly increased hazard ratios for CCB: 1.25 for CVD and 1.31 for all-cause mortality.
- The association between CCB and adverse outcomes was notably stronger in younger individuals compared to older participants.
Conclusions:
- Cardiac conduction block (CCB) is an independent risk factor associated with increased cardiovascular disease (CVD) and all-cause mortality in the general population.
- These findings underscore the importance of implementing preventive strategies targeting CCB to mitigate risks of CVD and mortality.
Background:
Although bundle branch block and atrioventricular block are recognized to be association with cardiovascular disease (CVD) and mortality, the relationship between cardiac conduction block (CCB) and both CVD and all-cause mortality has yet to be explored.
Aims:
To explore the relationship between CCB and CVD and all-cause mortality.
Methods And Results:
We included 145,805 subjects (mean age 49.7 years, 81.2% males) from the kailuan study. CCB was diagnosed through a 12‑lead electrocardiograph (ECG). Mortality and CVD events were ascertained through multiple sources, including a municipal social insurance institution, hospital records, death certificates, and regular active follow-ups. After a mean follow-up of 12.5 years, 18,301 cases developed all-cause mortality. After excluding 4443 subjects with CVD presence at baseline, 13,208 cases of CVD occurred among the 141,362 study subjects during follow-up. Compared with non-CCB group, the cumulative incidence of CVD and all-cause mortality for CCB group was 18.38% VS 12.14% and 33.45% VS 14.18%, respectively. The multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) with CCB group were 1.25(1.17-1.34) for CVD, and 1.31(1.25-1.38) for all-cause mortality. Additionally, there were generally stronger associations for CCB with all-cause mortality and CVD in younger participants compared with their older counterparts (Ps-interaction <0.001).
Conclusion:
CCB can increase the risk of CVD and all-cause mortality in the general population. Our findings highlight the importance of strategies for preventing CCB to reduce the risk of CVD and mortality.
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