The Prognostic Significance of Right Bundle Branch Block: A Meta-analysis of Prospective Cohort Studies
The Prognostic Significance of Right Bundle Branch Block: A Meta-analysis of Prospective Cohort Studies
复制标题
右束支传导阻滞的预后意义：前瞻性队列研究的荟萃分析。
DOI：
10.1002/clc.22454
复制
发表时间：
2015-10-01
影响因子：
2.7
通讯作者：
Wang, Shang
中科院分区：
文献类型：
--
作者：
Xiong, Yunyun;Wang, Lian;Wang, Shang
背景右束支分支传导阻滞（RBBB）的预后意义在不同研究中不一致。我们的目的是评估RBBB与（在一般人群和患有心脏病的患者中）和全因死亡率、心源性死亡、急性心肌梗死（MI）和心力衰竭（HF）的风险。和科克伦图书馆检索了截至2015年2月的前瞻性队列研究，这些研究报告了基线RBBB和全因死亡率、心源性死亡、MI，和随访时的HF。发表的数据进行荟萃分析主要是通过固定效应models.ResultsNineteen队列研究，包括201437参与者，平均随访期为1至246个月。对于RBBB的一般人群，与无BBB相比，全因死亡率的合并校正风险比（HR）为1.17（95%置信区间[CI]：1.03-1.33）。RBBB的一般人群心源性死亡风险增加（HR：1.43，95% CI：1.17-1.74）。对于RBBB和急性MI患者，院内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）。急性心衰患者全因死亡的合并危险比为1.11（95%CI：1.06-1.16），慢性心衰患者全因死亡的合并危险比为1.75（95%CI：1.38-2.22）。
BackgroundThe 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).HypothesisRBBB may be associated with increased risk of death.MethodsPubMed, 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.ResultsNineteen cohort studies including 201437 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).ConclusionsRight bundle branch block is associated with an increased risk of mortality in general population and patients with heart disease.