| Prognostic significance of left anterior hemiblock in patients with suspected coronary artery disease. | |
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MedLine Citation:
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PMID: 16139137 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study was designed to assess the functional and prognostic significance of left anterior hemiblock (LAHB) in patients with no history of myocardial infarction referred for dobutamine stress echocardiography (DSE). BACKGROUND: The significance of isolated LAHB in patients with suspected coronary artery disease (CAD) is unclear. METHODS: We studied 1,187 patients with suspected CAD and no history of myocardial infarction who underwent DSE and were followed for occurrence of cardiac death. RESULTS: Left anterior hemiblock was detected on baseline electrocardiogram in 159 patients (13%). Ischemia occurred more frequently in patients with LAHB (43% vs. 33%, p = 0.02). During a mean follow-up of 5.0 +/- 2.5 years, 125 patients (11%) died of cardiac causes. The annual cardiac death rate was 4.9% in patients with LAHB and 1.9% for patients without (p < 0.0001). Patients with both LAHB and an abnormal DSE had the highest annual cardiac death rate (6.3%). In a Cox multivariable analysis, independent predictors of cardiac death were age, smoking, history of heart failure, diabetes, and ischemia. Left anterior hemiblock was independently associated with increased risk of cardiac death among patients with normal DSE (hazard ratio 1.8, 95% confidence interval 1.1 to 3.8) and in patients with abnormal DSE (hazard ratio 1.7, 95% confidence interval 1.1 to 2.7). CONCLUSIONS: In patients with suspected CAD referred for stress testing, LAHB is associated with increased risk of cardiac death. This risk is persistent after adjustment for major clinical data and abnormalities on the stress echocardiogram. Therefore, isolated LAHB should not be considered a benign electrocardiographic abnormality in these patients. |
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Authors:
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Elena Biagini; Abdou Elhendy; Arend F L Schinkel; Stefan Nelwan; Vittoria Rizzello; Ron T van Domburg; Claudio Rapezzi; Guido Rocchi; Maarten L Simoons; Jeroen J Bax; Don Poldermans |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 46 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2005 Sep |
Date Detail:
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Created Date: 2005-09-05 Completed Date: 2005-12-05 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 858-63 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bundle-Branch Block / physiopathology*, ultrasonography Coronary Artery Disease / mortality, physiopathology*, ultrasonography Echocardiography, Stress Female Humans Male Middle Aged Prognosis Prospective Studies Risk Assessment Risk Factors Ventricular Dysfunction, Left / physiopathology*, ultrasonography |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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