Long-term outcomes of left bundle branch block in high-risk survivors of acute myocardial infarction: the VALIANT experience

Kent Stephenson; Hicham Skali; John J V McMurray; Eric J Velazquez; Philip G Aylward; Lars Valeur Køber; Frans Van de Werf; Harvey D White; Karen S Pieper; Robert M Califf; Scott D Solomon; Marc A Pfeffer

doi:10.1016/j.hrthm.2006.11.021

Long-term outcomes of left bundle branch block in high-risk survivors of acute myocardial infarction: the VALIANT experience

Kent Stephenson, Hicham Skali, John J V McMurray, Eric J Velazquez, Philip G Aylward, Lars Valeur Køber, Frans Van de Werf, Harvey D White, Karen S Pieper, Robert M Califf, Scott D Solomon, Marc A Pfeffer

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

26 Citationer (Scopus)

Abstract

Udgivelsesdato: 2007-Mar

Originalsprog	Engelsk
Tidsskrift	Heart Rhythm
Vol/bind	4
Udgave nummer	3
Sider (fra-til)	308-13
Antal sider	5
ISSN	1547-5271
DOI	https://doi.org/10.1016/j.hrthm.2006.11.021
Status	Udgivet - 2006

Bibliografisk note

Keywords: Aged; Aged, 80 and over; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Bundle-Branch Block; Captopril; Electrocardiography; Female; Follow-Up Studies; Heart Failure; Humans; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction; Predictive Value of Tests; Proportional Hazards Models; Research Design; Risk Factors; Stroke Volume; Survival Analysis; Survivors; Tetrazoles; Time Factors; Treatment Outcome; Valine; Ventricular Dysfunction, Left

Adgang til dokumentet

10.1016/j.hrthm.2006.11.021

Citationsformater

Stephenson, K., Skali, H., McMurray, J. J. V., Velazquez, E. J., Aylward, P. G., Køber, L. V., Van de Werf, F., White, H. D., Pieper, K. S., Califf, R. M., Solomon, S. D., & Pfeffer, M. A. (2006). Long-term outcomes of left bundle branch block in high-risk survivors of acute myocardial infarction: the VALIANT experience. Heart Rhythm, 4(3), 308-13. https://doi.org/10.1016/j.hrthm.2006.11.021

Stephenson, K, Skali, H, McMurray, JJV, Velazquez, EJ, Aylward, PG, Køber, LV, Van de Werf, F, White, HD, Pieper, KS, Califf, RM, Solomon, SD & Pfeffer, MA 2006, 'Long-term outcomes of left bundle branch block in high-risk survivors of acute myocardial infarction: the VALIANT experience', Heart Rhythm, bind 4, nr. 3, s. 308-13. https://doi.org/10.1016/j.hrthm.2006.11.021

@article{a0396f60118711df803f000ea68e967b,

title = "Long-term outcomes of left bundle branch block in high-risk survivors of acute myocardial infarction: the VALIANT experience",

abstract = "BACKGROUND: In survivors of myocardial infarction (MI), new left bundle branch block (LBBB) is associated with adverse outcomes, but its impact is not well described in post-MI patients with left ventricular (LV) systolic dysfunction and/or heart failure (HF). OBJECTIVES: The aim of this study was to determine if new LBBB is an independent predictor of long-term fatal and nonfatal outcomes in high-risk survivors of MI by reviewing data from the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. METHODS: In VALIANT, 14,703 patients with LV systolic dysfunction and/or HF were randomized to valsartan, captopril, or both a mean of 5 days after MI. Baseline ECG data were available from 14,259 patients. We assessed the predictive value of new LBBB for death and major cardiovascular outcomes after 3 years, adjusting for multiple baseline covariates including LV ejection fraction. RESULTS: At follow-up, patients with new LBBB (608 [4.2%]) compared with patients without new LBBB had more comorbidities and increased adjusted risk of death (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.2-1.6), cardiovascular death (HR 1.4, 95% CI 1.2-1.7), HF (HR 1.3, 95% CI 1.1-1.6), MI (HR 1.5, 95% CI 1.2-1.9), and the composite of death, HF, or MI (HR 1.4, 95% CI 1.2-1.6). CONCLUSION: In post-MI survivors with LV systolic dysfunction and/or HF, new LBBB was an independent predictor of all major adverse cardiovascular outcomes during long-term follow-up. This readily available ECG marker should be considered a major risk factor for long-term cardiovascular complications in high-risk patients after MI.",

author = "Kent Stephenson and Hicham Skali and McMurray, {John J V} and Velazquez, {Eric J} and Aylward, {Philip G} and K{\o}ber, {Lars Valeur} and {Van de Werf}, Frans and White, {Harvey D} and Pieper, {Karen S} and Califf, {Robert M} and Solomon, {Scott D} and Pfeffer, {Marc A}",

note = "Keywords: Aged; Aged, 80 and over; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Bundle-Branch Block; Captopril; Electrocardiography; Female; Follow-Up Studies; Heart Failure; Humans; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction; Predictive Value of Tests; Proportional Hazards Models; Research Design; Risk Factors; Stroke Volume; Survival Analysis; Survivors; Tetrazoles; Time Factors; Treatment Outcome; Valine; Ventricular Dysfunction, Left",

year = "2006",

doi = "10.1016/j.hrthm.2006.11.021",

language = "English",

volume = "4",

pages = "308--13",

journal = "Heart Rhythm",

issn = "1547-5271",

publisher = "Elsevier",

number = "3",

}

TY - JOUR

T1 - Long-term outcomes of left bundle branch block in high-risk survivors of acute myocardial infarction: the VALIANT experience

AU - Stephenson, Kent

AU - Skali, Hicham

AU - McMurray, John J V

AU - Velazquez, Eric J

AU - Aylward, Philip G

AU - Køber, Lars Valeur

AU - Van de Werf, Frans

AU - White, Harvey D

AU - Pieper, Karen S

AU - Califf, Robert M

AU - Solomon, Scott D

AU - Pfeffer, Marc A

N1 - Keywords: Aged; Aged, 80 and over; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Bundle-Branch Block; Captopril; Electrocardiography; Female; Follow-Up Studies; Heart Failure; Humans; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction; Predictive Value of Tests; Proportional Hazards Models; Research Design; Risk Factors; Stroke Volume; Survival Analysis; Survivors; Tetrazoles; Time Factors; Treatment Outcome; Valine; Ventricular Dysfunction, Left

PY - 2006

Y1 - 2006

N2 - BACKGROUND: In survivors of myocardial infarction (MI), new left bundle branch block (LBBB) is associated with adverse outcomes, but its impact is not well described in post-MI patients with left ventricular (LV) systolic dysfunction and/or heart failure (HF). OBJECTIVES: The aim of this study was to determine if new LBBB is an independent predictor of long-term fatal and nonfatal outcomes in high-risk survivors of MI by reviewing data from the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. METHODS: In VALIANT, 14,703 patients with LV systolic dysfunction and/or HF were randomized to valsartan, captopril, or both a mean of 5 days after MI. Baseline ECG data were available from 14,259 patients. We assessed the predictive value of new LBBB for death and major cardiovascular outcomes after 3 years, adjusting for multiple baseline covariates including LV ejection fraction. RESULTS: At follow-up, patients with new LBBB (608 [4.2%]) compared with patients without new LBBB had more comorbidities and increased adjusted risk of death (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.2-1.6), cardiovascular death (HR 1.4, 95% CI 1.2-1.7), HF (HR 1.3, 95% CI 1.1-1.6), MI (HR 1.5, 95% CI 1.2-1.9), and the composite of death, HF, or MI (HR 1.4, 95% CI 1.2-1.6). CONCLUSION: In post-MI survivors with LV systolic dysfunction and/or HF, new LBBB was an independent predictor of all major adverse cardiovascular outcomes during long-term follow-up. This readily available ECG marker should be considered a major risk factor for long-term cardiovascular complications in high-risk patients after MI.

AB - BACKGROUND: In survivors of myocardial infarction (MI), new left bundle branch block (LBBB) is associated with adverse outcomes, but its impact is not well described in post-MI patients with left ventricular (LV) systolic dysfunction and/or heart failure (HF). OBJECTIVES: The aim of this study was to determine if new LBBB is an independent predictor of long-term fatal and nonfatal outcomes in high-risk survivors of MI by reviewing data from the VALsartan In Acute myocardial iNfarcTion (VALIANT) trial. METHODS: In VALIANT, 14,703 patients with LV systolic dysfunction and/or HF were randomized to valsartan, captopril, or both a mean of 5 days after MI. Baseline ECG data were available from 14,259 patients. We assessed the predictive value of new LBBB for death and major cardiovascular outcomes after 3 years, adjusting for multiple baseline covariates including LV ejection fraction. RESULTS: At follow-up, patients with new LBBB (608 [4.2%]) compared with patients without new LBBB had more comorbidities and increased adjusted risk of death (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.2-1.6), cardiovascular death (HR 1.4, 95% CI 1.2-1.7), HF (HR 1.3, 95% CI 1.1-1.6), MI (HR 1.5, 95% CI 1.2-1.9), and the composite of death, HF, or MI (HR 1.4, 95% CI 1.2-1.6). CONCLUSION: In post-MI survivors with LV systolic dysfunction and/or HF, new LBBB was an independent predictor of all major adverse cardiovascular outcomes during long-term follow-up. This readily available ECG marker should be considered a major risk factor for long-term cardiovascular complications in high-risk patients after MI.

U2 - 10.1016/j.hrthm.2006.11.021

DO - 10.1016/j.hrthm.2006.11.021

M3 - Journal article

C2 - 17341394

SN - 1547-5271

VL - 4

SP - 308

EP - 313

JO - Heart Rhythm

JF - Heart Rhythm

IS - 3

ER -