Omer Aslam, Nadeem Hayat Mallick, Babar Alam, Muhammad Umar Farooq, Shoaib Ashraf, Ahmed Ali.
Association of The In-Hospital Outcome With Predictors In Acute Coronary Syndrome Patients With New Onset Left Bundle Branch Block (Lbbb).
J Cardiovascular Dis Jan ;13(1):1-4.

OBJECTIVE:To determine the association of the in-hospital mortality with predictors in acute coronary syndrome patients with new onset left bundle branch block (LBBB). MATERIAL AND METHODS: This descriptive cases series of 84 patients of acute coronary syndrome with LBBB were selected from emergency and indoor departments of Punjab Institute of cardiology from 09-12-2014 to 08-06-2015 (six months). After written and informed consent patients fulfilling the inclusion and exclusion criteria were included. Patients with ACS having LBBB at the time of admission presenting within 12 hours of onset of chest pain with age range 30-75 years were included while patients with normal left ventricular ejection fraction (EF >50%) were assessed by echocardiography at the time of inclusion. Patients with history of pacemaker implantation, previous history of ACS and previous LBBB (on previous ECG) were excluded from study. Patients were followed till discharge from hospital or death. RESULTS:Out of 84 patients 51(60.71%) were male while 33 (39.29%) were female. The mean age of the patients was 50.38 years with standard deviation 9.36 although the minimum age was 30 years and maximum age was 69 years. The mean height in LBBB patients was 160.6cm ± 6.39, mean weight 67.43kgs± 6.88, the mean BMI was 28.67kg/m2 ± 5.45. As regard to risk factors, diabetes mellitus was found in 23(27.38%) patients, hypertension was found in 32 (38.10%) patients and dyslipidemia was found in 32(38.10%) patients, family history of IHD was found in 11(13.10%) patients. The trend towards mortality was found to be 12(14.29%) in LBBB patients with acute coronary syndrome. Out of 51 male patients, death occurred in 12 (23.9%) patients while there was no mortality in 33 female patients. P value 0.003. Out of total 27 patients in age group 30-45, in hospital mortality occurred in 12 (44.4%) patients and 15 (55.5%) patients were discharged. All patients in age group 46-50 and 51-70 survived with 0% in hospital mortality. P value 0.000.Out of total 32 hypertensive patients, in hospital mortality occurred in 12 (37.5%) patients. All 52 (100%) non hypertensive patients were discharged with 0% in hospital mortality. P value 0.000.Out of total 23 diabetic patients, in hospital mortality occurred in 12 (52.1%) patients. All 61 (100%) non diabetic patients were discharged with 0% in hospital mortality. P value 0.000. Out of total 32 patients having dyslipidemia, in hospital mortality occurred in 12 (37.5%) patients. All of 52 patients with normal lipid profile survived with 0% in-hospital mortality. P value 0.000.Out of total 48 non obese patients, in hospital mortality occurred in 4 (8.3%) patients and 44 (91.6%) were discharged. Out of total 36 obese patients, in hospital mortality occurred in 8 (22.2%). P value 0.072.Out of total 11 patients with history of IHD, in hospital mortality occurred in 11 (100%). Out of total 73 patients without history of IHD, in hospital mortality occurred in 1 (1.3%) patient and 72 (98.6%) patients were discharged. P value 0.000 CONCLUSION:Frequency of in-hospital mortality is higher in acute coronary syndrome patients with New Left Bundle Branch Block (LBBB).

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