{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:27:41Z","timestamp":1788917261234,"version":"build-2803163510"},"reference-count":34,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2018,3,12]],"date-time":"2018-03-12T00:00:00Z","timestamp":1520812800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Patients with acute myocardial infarction (AMI) and bundle-branch block have poor prognoses. The new European Society of Cardiology guideline suggests a primary percutaneous coronary intervention strategy when persistent ischemic symptoms occur in patients with persistent ischemic symptoms and right bundle-branch block (RBBB), but the level of evidence is not high. In fact, the presence of RBBB may lead to the misdiagnosis of transmural ischemia and mask the early diagnosis of ST-elevation myocardial infarction. Moreover, new-onset RBBB is occasionally caused by AMI. Our study aims to investigate the prognostic value of new-onset RBBB in AMI.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods and Results<\/jats:title>\n<jats:p>We conducted a meta-analysis of studies to evaluate the prognostic value of RBBB in AMI patients. Of 914 primary records, five studies and 874 MI patients were included for meta-analysis. Compared with previous RBBB, AMI patients with new-onset RBBB had a higher risk of long-term mortality (RR, 1.66, 95% CI [1.31\u20132.09], <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 0.0%, <jats:italic>p<\/jats:italic> = 0.000, <jats:italic>n<\/jats:italic> = 2), ventricular arrhythmia (RR, 4.86, 95% CI [2.10\u201311.27], <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 0.0%, <jats:italic>p<\/jats:italic> = 0.000, <jats:italic>n<\/jats:italic> = 3), and cardiogenic shock (RR, 2.76, 95% CI [1.66\u20134.59], <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 0.0%, <jats:italic>p<\/jats:italic> = 0.000, <jats:italic>n<\/jats:italic> = 3), but a lower risk of heart failure (RR, 0.66, 95% CI [0.52\u20130.85], <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 2.50%, <jats:italic>p<\/jats:italic> = 0.001, <jats:italic>n<\/jats:italic> = 4). Compared with AMI patients with new-onset permanent RBBB, patients with new-onset transient RBBB had a lower risk of short-term mortality (RR, 0.20, 95% CI [0.11\u20130.37], <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 44.1%, <jats:italic>p<\/jats:italic> = 0.000, <jats:italic>n<\/jats:italic> = 4).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>New-onset RBBB is likely to increase long-term mortality, ventricular arrhythmia, and cardiogenic shock, but not heart failure in AMI patients. AMI patients with new-onset transient RBBB have a lower risk of short-term mortality than those with new-onset permanent RBBB. Revascularization therapies should be considered when persistent ischemic symptoms occur in patients with RBBB, especially new-onset RBBB.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.4497","type":"journal-article","created":{"date-parts":[[2018,3,12]],"date-time":"2018-03-12T05:16:37Z","timestamp":1520831797000},"page":"e4497","source":"Crossref","is-referenced-by-count":21,"title":["Prognostic value of new-onset right bundle-branch block in acute myocardial infarction patients: a systematic review and meta-analysis"],"prefix":"10.7717","volume":"6","author":[{"given":"Juntao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Zhengzhou University People\u2019s Hospital, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5721-6302","authenticated-orcid":true,"given":"Hongxing","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhengzhou University People\u2019s Hospital, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunling","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhengzhou University People\u2019s Hospital, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujuan","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Henan Province People\u2019s Hospital, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingchao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Henan Province People\u2019s Hospital, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijia","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Henan Province People\u2019s Hospital, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingjie","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Zhengzhou University People\u2019s Hospital, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2018,3,12]]},"reference":[{"issue":"5","key":"10.7717\/peerj.4497\/ref-1","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1161\/01.cir.0000134791.68010.fa","article-title":"ACC\/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction)","volume":"110","author":"Antman","year":"2004","journal-title":"Circulation"},{"issue":"6","key":"10.7717\/peerj.4497\/ref-2","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1053\/euhj.1997.0857","article-title":"Frequency and prognostic implications of conduction defects in acute myocardial infarction since the introduction of thrombolytic therapy","volume":"19","author":"Archbold","year":"1998","journal-title":"European Heart Journal"},{"issue":"3","key":"10.7717\/peerj.4497\/ref-3","first-page":"32","article-title":"Frequency and clinical outcome in conduction defects in acute myocardial infarction","volume":"21","author":"Bhalli","year":"2009","journal-title":"Journal of Ayub Medical College Abbottabad"},{"key":"10.7717\/peerj.4497\/ref-4","first-page":"I2","article-title":"The path to myocardial salvage by thrombolytic therapy","volume":"76","author":"Braunwald","year":"1987","journal-title":"Circulation"},{"issue":"8893","key":"10.7717\/peerj.4497\/ref-5","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/s0140-6736(94)91161-4","article-title":"Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomized trials of more than 1000 patients. 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