Open AccessThe Prognostic Significance of Right Bundle Branch Block: A Meta‐analysis of Prospective Cohort Studies
Author(s) -
Xiong Yunyun,
Wang Lian,
Liu Wenyan,
Hankey Graeme J.,
Xu Biao,
Wang Shang
Publication year - 2015
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22454
Subject(s) - medicine , hazard ratio , right bundle branch block , myocardial infarction , cardiology , confidence interval , population , prospective cohort study , heart failure , cohort study , electrocardiography , environmental health
Background The prognostic significance of right bundle branch block ( RBBB ) is inconsistent across studies. We aimed to assess the association between RBBB (in general population and patients with heart disease) and risk of all‐cause mortality, cardiac death, acute myocardial infarction ( MI ), and heart failure ( HF ). Hypothesis RBBB may be associated with increased risk of death. Methods PubMed , EMBASE , and the Cochrane Library up to February 2015 were searched for prospective cohort studies that reported RBBB at baseline and all‐cause mortality, cardiac death, MI , and HF at follow‐up. A meta‐analysis of published data was undertaken primarily by means of fixed‐effects models. Results Nineteen cohort studies including 201 437 participants were included with a mean follow‐up period ranging from 1 to 246 months. For general population with RBBB , the pooled adjusted hazard ratio ( HR ) for all‐cause mortality was 1.17 (95% confidence interval [ CI ]: 1.03–1.33) compared with no BBB . General population with RBBB had an increased risk of cardiac death ( HR : 1.43, 95% CI : 1.17–1.74). For patients with RBBB and acute MI , the pooled risk ratio was 2.31 (95% CI : 2.13–2.49) for in‐hospital mortality, 2.85 (95% CI : 2.46–3.30) for 30‐day mortality, and 1.96 (95% CI : 1.59–2.42) for longer‐term mortality. For acute HF patients, the pooled risk ratio of all‐cause mortality was 1.11 (95% CI : 1.06–1.16), and for chronic HF patients it was 1.75 (95% CI : 1.38–2.22). Conclusions Right bundle branch block is associated with an increased risk of mortality in general population and patients with heart disease.