Relation Between Serum Total Bilirubin Levels and Severity of Coronary Artery Disease in Patients With Non-ST-Segment Elevation Myocardial Infarction

Abstract

We studied 403 consecutive patients with non-ST-segment elevation myocardial infarction (NSTEMI). This population was divided into tertiles according to the SYNTAX score (SXscore). The high SXscore group was defined as an SXscore ≥13, and the low SXscore group as an SXscore <13. The total bilirubin (sTB) and direct bilirubin levels of patients were significantly higher in the high SXscore group (P = .001 and P = .007, respectively). There was a correlation between sTB and SXscore (r = .495; P = .005). On multivariate linear regression analyses, age (β = .100; P = .041), sTB levels (β = .171; P = .005), low-density lipoprotein cholesterol (β = .121; P = .014), and troponin-I (β = .124; P = .011) remained independent correlates of high SXscore. The mean follow-up period was 18.2 months. All-cause mortality rate was higher in the high SXscore group but did not reach significance (P = .058). In conclusion, high sTB level is independently associated with severity of coronary artery disease in patients with NSTEMI. However, no association was found with long-term mortality.

Relation of Direct, Indirect, and Total bilirubin to Adverse Long-term Outcomes Among Patients With Acute Coronary Syndrome

“…Kuwano et al 21 also reported that patients with higher TB level had lower instent restenosis risk after PCI. In addition, Gul et al 9 and Kaya et al 12 found no association between TB levels and long-term mortality in patients with STEMI or NSTEMI. In the present study, we reported that high levels of TB and DB were risk factors for adverse events in Chinese ACS patients.…”

“…Evidence suggested that SYNTAX score, which has been shown to predict major adverse events in patients with coronary heart disease, 20 was positively associated with TB in both STEMI and NSTEMI patients. 12,13 Celik et al 11 and Gul et al 9 demonstrated that high TB level was associated with PCI no-reflow as well as increased in-hospital MACE in patients with STEMI. On the contrary, Kim et al 8 found a negative correlation of TB levels and long-term outcomes in patients who underwent PCI.…”

“…8 However, others demonstrated that high bilirubin was a risk factor for in-hospital mortality in patients with acute coronary syndrome (ACS), 9−11 and was associated with SYNTAX score. 12,13 In addition, no study has examined the effect of DB and IDB on ACS. Therefore, we conducted this study to investigate the relation between bilirubin (TB, DB, and IDB) and longterm outcomes in ACS patients.…”

Neutrophil to Lymphocyte Ratio Predicts SYNTAX Score in Patients With Non-ST Segment Elevation Myocardial Infarction

“…The SYN-TAX score (SXscore) is an anatomic scoring system which quantifies the properties of a lesion including complexity, morphology, and location in the coronary vasculature. 5) It has been shown that the SXscore may predict short and long-term mortality in patients with CAD intervention. 6) The role of inflammation in the initiation and progression of coronary atherosclerosis is well described.…”

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

“…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. 22 Increasing TB was significantly associated with the risk of pump failure death but not for sudden death in patients with severe systolic heart failure.…”