Pattern of Coronary Artery Disease in Patients with Left Bundle Branch Block in Acute Coronary Syndrome

Authors

  • Hafsa Liaqat Department of Cardiology, Lady Reading Hospital (LRH), Peshawar, Pakistan.
  • Mohammad Adil Department of Cardiology, Lady Reading Hospital (LRH), Peshawar, Pakistan.
  • Faraz Ali Khan Department of Internal Medicine, Lady Reading Hospital (LRH), Peshawar, Pakistan.
  • Mohammad Ali Department of Plastic and Reconstructive Surgery, Northwest General Hospital (NWGH), Peshawar, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i5.1201

Keywords:

Left Bundle Branch Block, Coronary Artery Disease, Patterns

Abstract

Background: Left bundle branch block is a common manifestation at presentation of patients with acute coronary syndrome and is most often associated with coronary artery disease. However, CAD pattern of the patient, specifically with consideration of demographic factors like age, gender, as well as socioeconomic status, must be investigated. Knowledge of burden as well as prevalence of CAD in ACS patients with LBBB will help manage as well as diagnose effectively. Objective: To determine the frequency of pattern of coronary artery disease in patients with left bundle branch block in acute coronary syndrome. Study Design: Cross-sectional study. Study Duration and Setting: The study was conducted from August 2024 to February 2025 at the Department of Cardiology, LRH Peshawar. Methodology: The study consisted of 111 patients aged 30-70 with ACS and LBBB. Demographic data, including sex, age, BMI, and socioeconomic status, were elicited. Coronary angiography was done for the patients to find the number of blockages of coronary artery and its location. CAD was graded as single-vessel disease, double-vessel disease, or triple-vessel disease. Results: The majority of patients were male (79.3%), with a mean age of 58.60 ± 6.94 years. The most common CAD pattern was SVD (48.6%), followed by TVD (29.7%) and DVD (18%). Significant associations were found between socioeconomic status and CAD patterns, with middle-class patients having a higher incidence of SVD. Conclusion: Left bundle branch block (LBBB) is frequently associated with coronary artery disease in patients with acute coronary syndrome, with a predominant pattern of single-vessel disease.

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References

Yuan D, Chu J, Qian J, Lin H, Zhu G, Chen F, Liu X. New Concepts on the Pathophysiology of Acute Coronary Syndrome. Rev Cardiovasc Med. 2023 Apr 17;24(4):112.

https://doi.org/10.31083/j.rcm2404112.

Theofilis P, Oikonomou E, Chasikidis C, Tsioufis K, Tousoulis D. Pathophysiology of Acute Coronary Syndromes-Diagnostic and Treatment Considerations. Life (Basel). 2023 Jul 12;13(7):1543.

https://doi.org/10.3390/life13071543.

Noothi SK, Ahmed MR, Agrawal DK. Residual risks and evolving atherosclerotic plaques. Mol Cell Biochem. 2023 Dec;478(12):2629-2643.

https://doi.org/10.1007/s11010-023-04689-0.

Gherasie FA, Popescu MR, Bartos D. Acute Coronary Syndrome: Disparities of Pathophysiology and Mortality with and without Peripheral Artery Disease. J Pers Med. 2023 Jun 2;13(6):944.

https://doi.org/10.3390/jpm13060944.

Schulte KJ, Mayrovitz HN. Myocardial Infarction Signs and Symptoms: Females vs. Males. Cureus. 2023 Apr 13;15(4):e37522.

https://doi.org/10.7759/cureus.37522.

Ponnusamy SS, Vijayaraman P, Ellenbogen KA. Left Bundle Branch Block-associated Cardiomyopathy: A New Approach. Arrhythm Electrophysiol Rev. 2024 Sep 25;13:e15.

https://doi.org/10.15420/aer.2024.14.

Lukas Laws J, Lancaster MC, Ben Shoemaker M, Stevenson WG, Hung RR, Wells Q, et al. Arrhythmias as Presentation of Genetic Cardiomyopathy. Circ Res. 2022 May 27;130(11):1698-1722. https://doi.org/10.1161/CIRCRESAHA.122.319835.

Catrina BI, Batar F, Manitiu I, Prodan L, Tanasescu C, Filip T. Concepts of Cardiac Dyssynchrony and Dynamic Approach. Diagnostics (Basel). 2024 Apr 30;14(9):937.

https://doi.org/10.3390/diagnostics14090937.

Khalid K, Padda J, Ismail D, Abdullah M, Gupta D, Pradeep R, et al. Correlation of Coronary Artery Disease and Left Ventricular Hypertrophy. Cureus. 2021 Aug 30;13(8):e17550.

https://doi.org/10.7759/cureus.17550.

Ralapanawa U, Sivakanesan R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. J Epidemiol Glob Health. 2021 Jun;11(2):169-177.

https://doi.org/10.2991/jegh.k.201217.001.

Poznyak AV, Sadykhov NK, Kartuesov AG, Borisov EE, Melnichenko AA, Grechko AV, et al. Hypertension as a risk factor for atherosclerosis: Cardiovascular risk assessment. Front Cardiovasc Med. 2022 Aug 22;9:959285.

https://doi.org/10.3389/fcvm.2022.959285.

Ng IKS, Chia YW, See KC, Teo DBS. Approach to acute chest pain and acute coronary syndrome in adults. Singapore Med J. 2024 Feb 1;65(2):111-118.

https://doi.org/10.4103/singaporemedj.SMJ-2023-039.

Achim A, Péter OÁ, Cocoi M, Serban A, Mot S, Dadarlat-Pop A, et al. Correlation between Coronary Artery Disease with Other Arterial Systems: Similar, Albeit Separate, Underlying Pathophysiologic Mechanisms. J Cardiovasc Dev Dis. 2023 May 11;10(5):210.

https://doi.org/10.3390/jcdd10050210.

Assamti M, Benahmed I, Ismaili N, El Ouafi N. Acute double coronary occlusion and its misleading presentation: An unusual case report. Ann Med Surg (Lond). 2021 Dec 3;73:103133.

https://doi.org/10.1016/j.amsu.2021.103133.

Gurzău D, Dădârlat-Pop A, Caloian B, Cismaru G, Comşa H, Tomoaia R, et al. Major Left Bundle Branch Block and Coronary Heart Disease-Are There Any Differences between the Sexes? J Clin Med. 2021 May 25;10(11):2284.

https://doi.org/10.3390/jcm10112284.

Rahu QA, Farman MT, Sial JA. Pattern of coronary artery disease in patients with left bundle branch block in acute coronary syndrome. Med Channel. 2009;15(4):176-9.

Rahu QA, Farman MT, Sial JA. Pattern of Coronary Artery Disease in Patients with Left Bundle Branch Block in Acute Coronary Syndrome. Med Channel. 2009;15(4):176-179.

Balouch IJ, Ahmed I, Farooq F, Raza SA, Soomro NA, Khan MN, et al. Pattern of Coronary Artery Diseases in Patients Under 40 Years of Age with Acute Coronary Syndrome. Pak Heart J. 2021;54(02):144-147.

https://doi.org/10.47144/phj.v54i2.2089.

Ghanem I, El-damanhory A, Shaker A. Predictors and Morphologic Characteristics of Ischemic Left Bundle Branch Block. Zagazig University Med J. 2023.

https://doi.org/10.21608/zumj.2022.165421.2650.

Darmon A, Ducrocq G, Elbez Y. Prevalence, Incidence and Prognostic Implications of Left Bundle Branch Block in Patients with Chronic Coronary Syndromes (From the CLARIFY Registry). Circulation. 2021.

21. Avsec M, Fister M, Noč M, Radsel P. Alternating Bundle-Branch Block in Acute Coronary Syndrome. Cor Vasa. 2019;61:e68–e71. https://doi.org/10.1016/j.crvasa.2017.12.013.

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Published

2025-05-25

How to Cite

Liaqat, H., Adil, M., Khan, F. A., & Ali, M. (2025). Pattern of Coronary Artery Disease in Patients with Left Bundle Branch Block in Acute Coronary Syndrome. Indus Journal of Bioscience Research, 3(5), 598–602. https://doi.org/10.70749/ijbr.v3i5.1201

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