Acute Myocardial Infarction and Left Branch Bundle Block: Utility of the Sgarbossa Criteria

Introduction: Acute myocardial infarction (AMI) in the presence of left bundle branch block (LBBB) is a diagnostic challenge for the physician. The purpose of this article is to evaluate the usefulness of the Sgarbossa criteria for the diagnosis of AMI in patients with LBBB through a systematic review and meta-analysis. Method: Structured literature search in Medline, Lilacs, Ovid, and Embase from January 1996 to January 2018. Using the inclusion and exclusion criteria 3 reviewers selected the articles that answered the research question. The quality of the articles was evaluated using the QUADAS-2 tool. Results: 14 studies evaluated the Sgarbossa criteria using a score >= 3 points. With a total of 3689 patients, the sensitivity was 0.27 (95% CI: 0.24-0.29; p = 0.0000); specificity of 0.97 (95% CI: 0.96-0.98; p = 0.0001) LR(+) was 10.95 (6.28-19.11; p = 0.03), and LR(-) was 0.67 (0.56-0.81; p = 0.0000). Conclusions: The Sgarbossa criteria have a high specificity for the diagnosis of AMI with LBBB; however, the sensitivity and the LR(-) are low. It is necessary to evaluate new diagnostic algorithms and to validate the criteria for Colombia.