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Association of Right Bundle Branch Block with Ischemic Stroke Incidence: A UK Biobank Cohort Study
Dougho Park1,2, Sopheak Phoung3, Phoeuk Borei3
1Medical Research Institute, Pohang Stroke and Spine Hospital, Pohang, Republic of Korea.
Insights
Right bundle branch block (RBBB) significantly increases the risk of ischemic stroke (IS), atrial fibrillation, and mortality. This finding highlights the importance of monitoring RBBB patients for cardiovascular events.
Area of Science:
- Cardiology
- Neurology
- Epidemiology
Background:
- Right bundle branch block (RBBB) is often considered benign.
- The association between RBBB and ischemic stroke (IS) requires further investigation.
Purpose of the Study:
- To investigate the relationship between RBBB and the incidence of IS.
- To assess the association of RBBB with atrial fibrillation (AF) and all-cause mortality.
Main Methods:
- Retrospective cohort study using UK Biobank data (2004-2021).
- Included 3,634 participants with new-onset RBBB and 3,643 matched controls.
- Propensity score matching and time-dependent Cox regression analyses were applied.
Main Results:
- RBBB was independently associated with a 3.57-fold increased risk of IS.
- RBBB also showed significant associations with increased risk of AF (aHR 4.58) and all-cause mortality (aHR 2.66).
- Cumulative incidence of IS was higher in the RBBB group.
Conclusions:
- RBBB is associated with an increased risk of IS, independent of common comorbidities.
- These findings underscore the need for vigilant monitoring and management of RBBB patients.
- Further research is warranted to explore underlying mechanisms and optimize clinical strategies.
Introduction:
Right bundle branch block (RBBB) is often considered benign; however, its association with ischemic stroke (IS) remains unclear. We aimed to investigate the relationship between RBBB and the incidence of IS.
Methods:
We conducted a retrospective cohort study using the UK Biobank database (2004-2021), which included 3,634 participants with new-onset RBBB and 3,643 matched controls. The primary outcome was the incidence of IS, while the secondary outcomes included atrial fibrillation (AF) and all-cause mortality. We applied a propensity score matching with variables such as age, sex, presence of hypertension, diabetes, dyslipidemia, and the Charlson Comorbidity Index. Subsequently, time-dependent Cox regression analyses were performed to assess the association between RBBB and the outcomes.
Results:
The cumulative incidence of IS was higher in the RBBB group. RBBB was independently associated with an increased risk of IS (adjusted hazard ratio [aHR], 3.57; 95% confidence interval [CI], 2.12-6.03; p < 0.001), as well as AF (aHR, 4.58; 95% CI, 3.86-5.43; p < 0.001) and all-cause mortality (aHR, 2.66; 95% CI, 2.35-3.02; p < 0.001).
Conclusion:
RBBB was associated with an increased risk of IS, independent of age, sex, and other comorbidities. These findings emphasize the need for careful monitoring and management of patients with RBBB to mitigate the risk of IS and other adverse outcomes. Further research is needed to elucidate the underlying mechanisms and better inform clinical management strategies for patients with RBBB.
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