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Unraveling the spec...
Unraveling the spectrum of left bundle branch block in acute myocardial infarction : insights from the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT 2 and 3) trials
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Al-Faleh, Hussam (author)
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Fu, Yuling (author)
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Wagner, Galen (author)
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Goodman, Shaun (author)
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Sgarbossa, Elena (author)
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Granger, Christopher (author)
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Van de Werf, Frans (author)
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper,UCR
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Armstrong, Paul W. (author)
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(creator_code:org_t)
- Elsevier BV, 2006
- 2006
- English.
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In: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 151:1, s. 10-5
- Related links:
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http://www.ncbi.nlm....
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: Left bundle branch block (LBBB) complicates the diagnosis of acute myocardial infarction (AMI). The Sgarbossa criteria were developed from GUSTO I to surmount this diagnostic challenge but have not been prospectively validated in a large population with presumed AMI. We evaluated their utility in the diagnosis and risk stratification of AMI patients in ASSENT 2 & 3. METHODS: Baseline electrocardiograms (ECG) of LBBB patients were scored using Sgarbossa's criteria (0-10) by 2 readers blinded to the CK/CK-MB data and clinical outcomes; 267 (1.2%) patients had LBBB on their baseline ECG. RESULTS: Among 253 LBBB patients with available peak CK/CK-MB data, 158 (62.5%) had peak CK/CK-MB levels > 2x ULN, thereby qualifying for the diagnosis of AMI. A Sgarbossa score of 3 was shown in 48.7% of LBBB patients with elevated CK/CK-MB versus in 12.6% of those without a CK/CK-MB rise (P < .001). Patients with higher Sgarbossa scores, ie, 3, had a higher mortality compared with those with a score < 3, (23.5% vs 7.7% at 30 days P < .001; and 33.7% vs 20.2% at 1 year, P < .001, respectively). CONCLUSIONS: Our findings validate the utility of Sgarbossa criteria for diagnosing AMI in the setting of LBBB. These criteria provide a simple and practical diagnostic approach to risk stratify this diagnostically challenging high-risk group and optimize risk-benefit of acute therapy.
Keyword
- Aged
- Bundle-Branch Block/*complications
- Clinical Trials
- Electrocardiography/methods
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction/*complications/*diagnosis
- Prognosis
- Risk Assessment
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Al-Faleh, Hussam
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Fu, Yuling
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Wagner, Galen
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Goodman, Shaun
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Sgarbossa, Elena
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Granger, Christo ...
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show more...
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Van de Werf, Fra ...
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Wallentin, Lars, ...
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Armstrong, Paul ...
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- Articles in the publication
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American Heart J ...
- By the university
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Uppsala University