Baskent University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
Aim: The presence of left bundle branch block (LBBB) in the surface electrocardiogram makes the evalaution of patients for suspected angina pectoris difficult. A newly developed LBBB in patients with acute chest pain is an indication for primary percutaneous coronary intervention. However, it is difficult to evaluate the coronary artery disease (CAD) in stable patients with LBBB. In this study, we aimed to investigate the baseline demographic characteristics, electrocardiographic and echocardiographic findings in LBBB patients who had a preliminary diagnosis of CAD.
Material and Methods: We enrolled a total of 216 consecutive patients with a LBBB who had undergone coronary angiography. Of these patients, severe coronary artery disease did not find in 123 (56%) patients, while 93 (44%) patients had severe coronary artery disease
Results: The frequency of male sex, diabetes mellitus and hyperlipidemia were significantly higher in the CAD group (p=0.007, p=0.001, and p=0.012, respectively). Comparasion of electrocardiographic findings revealed no significant difference betweent the goups. In terms of the echocardiography findings, the left venticular ejection fraction was significantly lower and the left venticular end-diastolic volume was significantly higher in patients with CAD. We noted that patients with CAD had significiantly elevated creatinine levels compared to those who did not.
Conclusion: The significant risk factors for CAD among patients with LBBB included diabetes mellitus, elevated creatinine levels, male sex, advanced age, and low left venticular ejection fraction. These risk factors should be incorporated with non-invasive tests in patients with who had a preliminary diagnosis of CAD, and a conventional angiography should be considered in these patients in an attempt to increase the specificity and sensitivity of the available diagnostic tests.
Keywords: Left Bundle Branch Block; Coronary Artery Disease; Diabetes Mellitus.