Ono Katsuhiro, Uchimoto Sadahiko, Miyazaki Masamune, Honda Natsuki, Mori Katsuhito, Morioka Tomoaki, Imai Takumi, Shoji Tetsuo, Emoto Masanori
Department of Internal Medicine, Fujiidera Municipal Hospital, Fujiidera 583-0012, Japan.
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan.
J Clin Med. 2022 Aug 8;11(15):4618. doi: 10.3390/jcm11154618.
Complete right bundle branch block (CRBBB) is generally regarded as a clinically insignificant abnormality on an electrocardiogram, although its predictive value for cardiovascular events in type 2 diabetes mellitus (T2DM) is unknown. We examined the association of CRBBB with cardiovascular events during a 6-year follow-up in a single-center cohort study. The Fine-Gray model was used to analyze the independent association between CRBBB and composite cardiovascular events including cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for heart failure during follow up. We analyzed the data of 370 T2DM patients including 62 patients with pre-existing heart disease. CRBBB was found in 34 patients (9.2%). The composite cardiovascular outcome was recorded in 32 patients. When analyzed with the Fine-Gray model with inverse probability of treatment weighting, CRBBB was significantly associated with a higher risk of the cardiovascular outcome (hazard ratio, 2.55; 95% confidence interval, 1.04 to 6.26; = 0.041). This association remained significant even after further adjustment for each of the potential confounders. This study suggested that CRBBB was an independent predictor of cardiovascular events in T2DM. Further studies with a larger sample size are warranted.
完全性右束支传导阻滞(CRBBB)在心电图上通常被认为是一种临床上无显著意义的异常,尽管其对2型糖尿病(T2DM)心血管事件的预测价值尚不清楚。在一项单中心队列研究中,我们对CRBBB与6年随访期间心血管事件的关联进行了研究。采用Fine-Gray模型分析CRBBB与复合心血管事件之间的独立关联,复合心血管事件包括随访期间的心血管死亡、非致死性心肌梗死、非致死性卒中以及因心力衰竭住院。我们分析了370例T2DM患者的数据,其中包括62例已有心脏病的患者。34例患者(9.2%)发现有CRBBB。32例患者记录了复合心血管结局。当采用治疗权重逆概率的Fine-Gray模型进行分析时,CRBBB与心血管结局风险较高显著相关(风险比,2.55;95%置信区间,1.04至6.26;P = 0.041)。即使对每个潜在混杂因素进行进一步调整后,这种关联仍然显著。本研究表明,CRBBB是T2DM中心血管事件的独立预测因素。有必要进行更大样本量的进一步研究。