Fatima Qurratulain, Maroosh Mumtaz, Zameer-ul Asar.
In patients with left bundle branch block, severity of coronary artery disease and demographic factors.
J Cardiovascular Dis Jan ;12(2):33-6.

INTRODUCTION: Coronary artery disease (CAD) is a prevalent disorder and it is a leading cause of death all over the world. The prevalence of CAD is high in patients having LBBB and is also associated with increased mortality. Therefore the assessment of CAD may help in providing prognostic information. The study was planned to evaluate the severity of CAD in patients having LBBB. OBJECTIVE:The objective of the study was to look for the presence and extent of CAD and characteristics of the patients having LBBB with and without CAD. MATERIAL AND METHODS:The study was done at Punjab Institute of Cardiology, Lahore from Feb 2012 to Aug 2012. A total of 200 patients with LBBB were included in this study. Demographic variables of the patients were noted on a pre-specified proforma. Coronary angiography was performed to assess the presence, extent and severity of CAD. Significant CAD was considered if the luminal narrowing was more than 50%. RESULTS:According to data mean age was 53.38 +9.57 years. 123 (61.5%) patients out of 200 were male and 77 (38.5%) were female. Diabetes was present in 60 (30%) and hypertension was found in 136 (68%) patients.132(66%) patients had CAD. 38 patients (19%) had severe triple vessel or Left Main Stem involvement. 63 patients (31.5%) had two vessel and 31(15.5%) patients had single vessel CAD. Left Main Stem was involved in 12(6%) of patients of LBBB. In 56.5% of patients left anterior descending artery (LAD) was involved. 43(32.6%) patients were diabetic and 94(71.2%) were hypertensive among LBBB patients with CAD. 88(66.7%) of the patients were males and 44(33.3%) were females. Mean age of patients of LBBB having CAD was 56.51±8.37 and patients without having CAD was 47.29±8.85. So, the patients with LBBB and CAD were more likely to be older and males than patients with LBBB and no CAD. CONCLUSION:On the basis on this study, it is clear that LBBB patients have a quite high probability of severe CAD based on coronary angiography. The demographic characteristics like advanced age and male gender also help to differentiate LBBB patients with concomitant coronary artery disease from those without coronary involvement. Therefore early invasive approach in patients with LBBB should be warranted. KEY WORDS:Coronary artery disease; Left bundle branch block; Coronary angiography.

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