Prognostic Value of Total Bilirubin in Patients With ST-Segment Elevation Acute Myocardial Infarction Undergoing Primary Coronary Intervention

Gül, Mehmet; Uyarel, Hüseyin; Ergelen, Mehmet; Akgül, Özgür; Karaca, Gurkan; Turen, Selahattin; Uğur, Murat; Ertürk, Mehmet; Kul, Şeref; Surgit, Özgür; Bozbay, Mehmet; Uslu, Nevzat

doi:10.1016/j.amjcard.2012.09.011

Cited by 60 publications

(52 citation statements)

References 28 publications

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“…Gul et al . [21] demonstrated that high TB was one of the independent predictors of in-hospital cardiovascular mortality and morbidity in patients with acute STEMI.…”

Section: Discussionmentioning

confidence: 99%

A novel predictor of infarct-related artery patency before percutaneous intervention and in-hospital outcomes for ST-segment elevation myocardial infarction patients: serum bilirubin level

Acet¹,

Ertş²,

Akıl³

et al. 2014

pwki

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IntroductionPrevious studies have reported a relationship between serum bilirubin levels and coronary artery disease (CAD). However, data are rare up to now regarding the relation of bilirubin levels with infarct-related artery (IRA) patency in the setting of ST-segment elevation myocardial infarction (STEMI). Moreover, previous studies reported that increased bilirubin was related to impaired post-intervention coronary flow. To our knowledge, the association between serum total bilirubin (TB) levels and pre-primary percutaneous coronary intervention (PCI) with patency of IRA flow in STEMI patients has not been investigated.AimTo evaluate the association of TB with pre-primary PCI, coronary flow and in-hospital major adverse cardiac events (MACE) in patients with STEMI.Material and methodsA total of 360 consecutive patients with STEMI (mean age = 61.4 ±13.7 years) admitted within 12 h from the time of symptom onset were enrolled. Patients were divided into 2 groups based on the serum TB levels. We defined normal flow as pre-PCI TIMI 3 flow, while impaired flow was defined as pre-PCI TIMI ≤ 2 flow.ResultsPre-PCI impaired flow was higher in the TB group than pre-PCI normal flow (p < 0.001). In-hospital mortality and MACE were significantly higher in the high TB group (p = 0.002, p < 0.001 respectively). In the receiver operating characteristic curve analysis, TB > 0.825 mg/dl predicted impaired IRA flow before p-PCI with a sensitivity of 79% and specificity of 71%.ConclusionsThe TB is an inexpensive and readily available marker for STEMI patients undergoing PCI. It can be used for risk stratification in this patient population.

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“…Gul et al . [21] demonstrated that high TB was one of the independent predictors of in-hospital cardiovascular mortality and morbidity in patients with acute STEMI.…”

Section: Discussionmentioning

confidence: 99%

A novel predictor of infarct-related artery patency before percutaneous intervention and in-hospital outcomes for ST-segment elevation myocardial infarction patients: serum bilirubin level

Acet¹,

Ertş²,

Akıl³

et al. 2014

pwki

View full text Add to dashboard Cite

show abstract

“…Huang et al found that the incidence of cardiovascular death and all-cause mortality in patients with STB levels > 11.97 μmol/L was lower than in patients with STB ≤ 8.55 μmol/L [5]. Rahma et al found that mortality in patients with cardiovascular disease was inversely correlated with the level of STB [23]; however, for patients treated by PCI for STEMI, a higher STB level was associated with a lower incidence of in-hospital mortality, although no differences were found in the long-term mortality between the groups [24].…”

Section: Discussionmentioning

confidence: 94%

Serum total bilirubin and long-term outcome in patients undergoing percutaneous coronary intervention

Zhang

Kan

Yao

et al. 2014

CIM

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Purpose: The purpose of this study was to investigate the associated between serum total bilirubin (STB) levels and long-term outcomes in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).Methods: A total of 1,273 consecutive patients were enrolled. Patients were grouped according to their baseline STB levels: Group 1 (STB < 3.4 μmol/L), Group 2 (3.4 μmol/L ≤ STB ≤ 10.3 μmol/L), Group 3 (10.3 μmol/L < STB ≤ 17.1 μmol/L), and Group 4 (STB > 17.1 μmol/L) and the rate of major adverse cardiovascular events (MACE) was determinedResults: A total of 1,152 patients were successfully followed up (90.5%) for a mean period of 30 ± 5 months, including 187 patients experiencing a major adverse cardiovascular event (MACE: death from any cause, myocardial infarction, repeat revascularization or readmission). The MACE rate in Groups 3 and 4 was lower than in Groups 1 and 2 (P < 0.01). After adjusted the confounding factors with Cox regression analysis, the MACE rates in Groups 2-4 were still lower than in Group 1 (Group 2, RR=0.293, 95% CI 0.167-0.517, P<0.01; Group 3, RR=0.142, 95% CI 0.065-0.312, P<0.01; Group 4, RR=0.134, 95% CI 0.071-0.252, P<0.01). The cumulative survival rates of Groups 3 and 4 were higher than that of Groups 1and 2 (P<0.01).Conclusions: High STB concentration is associated with lower MACE in patients with ACS after PCI.

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“…25 The present findings are in agreement with previously published data showing that serum high TB is independently associated with in-hospital adverse events in patients with STEMI who underwent primary PCI, although serum TB was taken on the morning after primary PCI in that study. 20 To our knowledge, this is the first study to demonstrate an association between initial TB and in-hospital adverse clinical outcomes in patients with STEMI undergoing primary PCI with DES. Bleeding complications at the access site or other focus and other complications related to the primary PCI may have an effect on serum TB level.…”

Section: Discussionmentioning

confidence: 99%

“…No association was found, however, with long-term mortality. 20 Increased serum TB was independently associated with severity of CAD on SYNTAX score in patients with NSTEMI. 21 Such an association between higher serum TB and higher SYNTAX score was also found in patients with STEMI.…”

Section: Discussionmentioning

confidence: 99%

Initial Total Bilirubin and Clinical Outcome in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention With Drug-Eluting Stents

Chung

Yang

Shin

et al. 2016

Circ J

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Prognostic Value of Total Bilirubin in Patients With ST-Segment Elevation Acute Myocardial Infarction Undergoing Primary Coronary Intervention

Cited by 60 publications

References 28 publications

A novel predictor of infarct-related artery patency before percutaneous intervention and in-hospital outcomes for ST-segment elevation myocardial infarction patients: serum bilirubin level

A novel predictor of infarct-related artery patency before percutaneous intervention and in-hospital outcomes for ST-segment elevation myocardial infarction patients: serum bilirubin level

Serum total bilirubin and long-term outcome in patients undergoing percutaneous coronary intervention

Initial Total Bilirubin and Clinical Outcome in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention With Drug-Eluting Stents

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