Serum Bilirubin Concentration in Patients With an Established Coronary Artery Disease

Abstract

SummaryBilirubin has been considered an antioxidant, with capacity to remove reactive species of oxygen. Studies have suggested that an increased bilirubin level promotes protection against atherosclerosis.The case group was composed of 100 patients with coronary artery disease and the control group 100 patients with normal coronaries. Blood samples were collected to determine bilirubin concentrations. Bivariate analysis, multiple logistic regression models, and Spearman's correlation index were performed. A P value < 0.05 was considered to be significant.The case group was predominantly composed of men and the control group of women, with a mean age of 60 ± 8.8 versus 56 ± 10.9 (P = 0.015). The total bilirubin average was significantly higher in the control group than in the case group (0.76 mg/dL versus 0.39 mg/dL, P < 0.001). The level of ultrasensitive C reactive protein (us-CRP) was increased in the case group (3.63 mg/L versus 0.93 mg/L, P < 0.001). Although the correlation index for this inverse association has been weak, both are independently associated with a higher prevalence of coronary artery disease, total bilirubin ≤ 0.56 mg/dL (OR: 10.04; IC: 3.48-28.90; P < 0.001), and ultrasensitive C reactive protein > 3 mg/L (OR: 1.17; IC: 1.04-1.33; P = 0.009).Reduced serum levels of bilirubin were shown to be associated with a higher prevalence of coronary artery disease emerging as a new potential risk factor marker. Additional studies are still necessary to confirm and demonstrate the association of these findings with clinical outcomes. (Int Heart J 2010; 51: 86-91)

Heme Oxygenase in the Regulation of Vascular Biology: From Molecular Mechanisms to Therapeutic Opportunities

“…Administration of BR or its precursor BV to rodents can suppress I=R injury (219,256). It has been demonstrated that low serum BR levels correlate with an increased risk for CAD and oxidative metabolites of BR are detected in atherosclerotic lesions (92,127,255). However, there is no clinical evidence supporting the hypothesis that the protection provided by BR or BV in the ischemic myocardium could be clinically significant.…”

Moderate hyperbilirubinemia improves renal hemodynamics in ANG II-dependent hypertension

“…These results indicate that improvement of renal hemodynamics may be one mechanism by which moderate hyperbilirubinemia lowers blood pressure in this model. bilirubin; renal blood flow; glomerular filtration rate; morpholino; indinavir; UGT1A1 POPULATION STUDIES HAVE REVEALED that individuals with moderately elevated plasma bilirubin have reduced incidence of hypertension, renal disease, and coronary artery disease (3,4,7,9,12,15). Despite this strong correlation, the mechanism(s) that links mild increases in plasma bilirubin with the prevention of cardiovascular disease remains unknown.…”

New Noninvasive Modalities in Coronary Angiography - Diagnostic Values of New Biomarkers for Cardiovascular Disease

“…Bilirubin has been considered an antioxidant, with capacity to remove reactive species of oxygen. Recent data advocates the idea that an increased bilirubin level promotes protection against atherosclerosis (Ghem et al, 2010). The heme oxygenase responsible for the degradation of heme grouping of hemoglobin is a stress inducible enzyme with antioxidative properties .…”

“…The products of its reaction (bilirubine, carbon monoxide and iron) develop a potential protective role against atherosclerosis (Hoekstra et al, 2004). Studies have suggested that different circulating forms of bilirubin have the capacity to remove a variety of reactive species of oxygen, and inhibit the oxidation of LDL particles and the chemotaxis of monocytes, all of which are crucial steps in atherogenesis (Ghem et al, 2010). In a study we have done , we assessed the diagnostic performance and relationship of bilirubin with hs-CRP and t-Hcy for cardiovascular disease in men and women in an angiographically documented design.…”