Coronary artery diseaseLong-Term Cardiovascular Outcomes in Patients With Angina Pectoris Presenting With Bundle Branch Block
Section snippets
Methods
Complete medical records of eligible patients were obtained through resources of the Rochester Epidemiology Project (REP), which allows comprehensive capture of details of health care experiences including outpatient care of all residents of Olmsted County, Minnesota (OC).9 The OC Health Care Utilization and Expenditures Database, which is linked to the REP, contains detailed line-item information on health services use and expenditures incurred by every member of the population for as long as
Results
During the study period, 6,801 residents of OC presented to an emergency department with a first episode of acute chest pain. Of these 2,271 (33.4%) met the criteria for angina and were followed as study subjects for a median of 7.3 years for MACEs. Of ineligible patients cardiac disease accounted for 6.7% of presenting syndromes including ST-segment elevation myocardial infarction in 5.5%, stable angina pectoris in 1.0%, and aortic dissection in 0.2%. Noncardiac causes of chest pain accounted
Discussion
Our study is the longest and most comprehensive observation of a population-based cohort of consecutive patients with angina who displayed RBBB or LBBB on initial electrocardiogram. During follow-up, which extended into the current era, the pattern of RBBB on presenting electrocardiogram predicted poor cardiovascular outcomes over 7 years and greater mortality rate of 15 years compared to those without BBB, but these differences were largely attributable to a greater burden of associated risk
Acknowledgment
We acknowledge Jonathan L. Halperin, MD, for his masterful editorial comments.
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Cited by (0)
This study was made possible by the Rochester Epidemiology Project, Rochester, Minnesota (Grant R01-AR30582 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, Maryland).
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Drs. Bansilal and Aneja contributed equally to this article.