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Long-term outcomes of left bundle branch block in high-risk survivors of acute myocardial infarction: the VALIANT experience.
- Source :
- Heart Rhythm; Mar2007, Vol. 4 Issue 3, p308-313, 6p
- Publication Year :
- 2007
-
Abstract
- <bold>Background: </bold>In survivors of myocardial infarction (MI), new left bundle branch block (LBBB) is associated with adverse outcomes, but its impact is not well described in post-MI patients with left ventricular (LV) systolic dysfunction and/or heart failure (HF).<bold>Objectives: </bold>The aim of this study was to determine if new LBBB is an independent predictor of long-term fatal and nonfatal outcomes in high-risk survivors of MI by reviewing data from the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial.<bold>Methods: </bold>In VALIANT, 14,703 patients with LV systolic dysfunction and/or HF were randomized to valsartan, captopril, or both a mean of 5 days after MI. Baseline ECG data were available from 14,259 patients. We assessed the predictive value of new LBBB for death and major cardiovascular outcomes after 3 years, adjusting for multiple baseline covariates including LV ejection fraction.<bold>Results: </bold>At follow-up, patients with new LBBB (608 [4.2%]) compared with patients without new LBBB had more comorbidities and increased adjusted risk of death (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.2-1.6), cardiovascular death (HR 1.4, 95% CI 1.2-1.7), HF (HR 1.3, 95% CI 1.1-1.6), MI (HR 1.5, 95% CI 1.2-1.9), and the composite of death, HF, or MI (HR 1.4, 95% CI 1.2-1.6).<bold>Conclusion: </bold>In post-MI survivors with LV systolic dysfunction and/or HF, new LBBB was an independent predictor of all major adverse cardiovascular outcomes during long-term follow-up. This readily available ECG marker should be considered a major risk factor for long-term cardiovascular complications in high-risk patients after MI. [ABSTRACT FROM AUTHOR]
- Subjects :
- MYOCARDIAL infarction
HEART failure
MORTALITY
CARDIOLOGY
ACE inhibitors
CAPTOPRIL
HETEROCYCLIC compounds
ANGIOTENSIN receptors
HEART ventricle diseases
BUNDLE-branch block
COMPARATIVE studies
ELECTROCARDIOGRAPHY
EXPERIMENTAL design
LEFT heart ventricle
LONGITUDINAL method
RESEARCH methodology
MEDICAL cooperation
MULTIVARIATE analysis
RESEARCH
SURVIVAL analysis (Biometry)
TIME
EVALUATION research
VALINE
RANDOMIZED controlled trials
TREATMENT effectiveness
PREDICTIVE tests
PROPORTIONAL hazards models
STROKE volume (Cardiac output)
PREVENTION
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 15475271
- Volume :
- 4
- Issue :
- 3
- Database :
- Supplemental Index
- Journal :
- Heart Rhythm
- Publication Type :
- Academic Journal
- Accession number :
- 24218361
- Full Text :
- https://doi.org/10.1016/j.hrthm.2006.11.021