Xiong Yunyun, Wang Lian, Liu Wenyan, Hankey Graeme J, Xu Biao, Wang Shang
Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Department of Cardiology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Clin Cardiol. 2015 Oct;38(10):604-13. doi: 10.1002/clc.22454. Epub 2015 Oct 5.
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).
RBBB may be associated with increased risk of death.
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.
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).
Right bundle branch block is associated with an increased risk of mortality in general population and patients with heart disease.
在各项研究中，右束支传导阻滞（RBBB）的预后意义并不一致。我们旨在评估RBBB（在普通人群和心脏病患者中）与全因死亡率、心源性死亡、急性心肌梗死（MI）和心力衰竭（HF）风险之间的关联。
RBBB可能与死亡风险增加相关。
检索了截至2015年2月的PubMed、EMBASE和Cochrane图书馆，查找在基线时报告有RBBB以及在随访时报告有全因死亡率、心源性死亡、MI和HF的前瞻性队列研究。主要通过固定效应模型对已发表的数据进行荟萃分析。
纳入了19项队列研究，共201437名参与者，平均随访期为1至246个月。对于有RBBB的普通人群，与无束支传导阻滞相比，全因死亡率的合并调整风险比（HR）为1.17（95%置信区间[CI]：1.03 - 1.33）。有RBBB的普通人群心源性死亡风险增加（HR：1.43，95% CI：1.17 - 1.74）。对于有RBBB和急性MI的患者，住院死亡率的合并风险比为2.31（95% CI：2.13 - 2.49），30天死亡率为2.85（95% CI：2.46 - 3.30），长期死亡率为1.96（95% CI：1.59 - 2.42）。对于急性HF患者，全因死亡率的合并风险比为1.11（95% CI：1.06 - 1.16），对于慢性HF患者为1.75（95% CI：1.38 - 2.22）。
右束支传导阻滞与普通人群和心脏病患者的死亡风险增加相关。
