Bilirubin alone as a biomarker for short-term mortality in acute-on-chronic liver failure: an important prognostic indicator

López-Velázquez, Jorge A.; Chávez-Tapia, Norberto C.; Ponciano-Rodríguez, Guadalupe; Sánchez-Valle, Vicente; Caldwell, Stephen H.; Uribe, Misael; Méndez-Sánchez, Nahúm

doi:10.1016/s1665-2681(19)30910-x

Cited by 73 publications

(49 citation statements)

References 28 publications

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“…However, the concentrations of serum bilirubin increased along with the increased severity of fibrosis among CHC patients [22]. High levels of bilirubin or combined prognostic index including bilirubin were able to predict short-term mortality in the patients with acute-on-chronic liver failure [23,24]. Meantime, abnormal bilirubin values were even more strongly associated with poor clinical outcome at baseline and up to five years follow-up in the patients with primary billiary cirrhosis [25].…”

Section: Introductionmentioning

confidence: 99%

The Relationship between Serum Bilirubin and Elevated Fibrotic Indices among HBV Carriers: A Cross-Sectional Study of a Chinese Population

Zhang

Xiao

et al. 2016

IJMS

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The study probed the association between bilirubin and hepatitis B virus (HBV) infection and progression. A cross-sectional analysis of 28,500 middle aged and elderly Chinese participants was performed to analyze the differences of bilirubin in terms of hepatitis B surface antigen (HBsAg) positive or negative and the correlation between bilirubin and severity of hepatic fibrosis estimated by non-invasive indices. Bilirubin was significantly higher in the HBsAg (+) group than the HBsAg (−) group. Higher bilirubin levels were consistently associated with elevated liver fibrosis indices among HBsAg carriers. Compared with quartile 1 of total bilirubin (TBil), the multivariable-adjusted ORs (95% CIs) for elevated fibrosis indices of quartile 4 were 2.24 (95% CIs, 1.57–3.21) estimated by fibrosis 4 score (FIB-4) and 2.22 (95% CIs, 1.60–3.08) estimated by aspartate transaminase to platelet ratio index (APRI). In addition, direct bilirubin (DBil) had a stronger association with elevated liver fibrosis indices than did indirect bilirubin (IBil). Furthermore, the relationship between DBil and elevated fibrosis indices was more robust among participants who were female, overweight or had central fat distribution. These findings suggested that bilirubin levels, especially DBil, were independently associated with an increased risk of increased fibrosis indices.

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Section: Introductionmentioning

confidence: 99%

The Relationship between Serum Bilirubin and Elevated Fibrotic Indices among HBV Carriers: A Cross-Sectional Study of a Chinese Population

Zhang

Xiao

et al. 2016

IJMS

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“… 25 High serum bilirubin is associated with hepatic decompensation and was solely found to be a prognostic marker in patients with chronic liver disease in which aminotransferases may be mildly elevated. 26 We observed that baseline ALT and AST were significant predictors for severity of liver injury on linear regression analysis. High baseline aminotransferases were also associated with high risk of acute liver failure in patients with DILI.…”

Section: Discussionmentioning

confidence: 72%

Predictors of intravenous amiodarone induced liver injury

Diab

Kamel

Abdel-Hamid³

2017

The Egyptian Heart Journal

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BackgroundIntravenous (IV) amiodarone may be associated with liver injury that may necessitate drug discontinuation. The prediction of amiodarone induced liver injury (AILI) and its severity may help careful patient monitoring or the choice of other measures alternative to amiodarone in high risk patients. Little is known regarding predictors of AILI.ObjectivesTo address the predictors of AILI and its severity.MethodsThe study included 180 patients indicated for IV amiodarone therapy who were divided into 2 groups: cases (90 patients) who developed AILI, and controls (90 patients) who did not develop AILI. AILI was defined as aminotransferase (ALT and AST) elevation by ⩾2 folds of baseline levels. Severe AILI was defined as enzyme elevation by >5 folds of baseline values.ResultsMultivariate analysis showed that the presence of cardiomyopathy (P = 0.032), congestive hepatomegaly (P = 0.001), increasing baseline total bilirubin (P < 0.0001), direct current cardioversion (P = 0.015), and increasing dose of amiodarone (P = 0.014) to be independent predictors for AILI. Regarding severity of AILI, inotropic support (P = 0.034), congestive hepatomegaly (P = 0.012), increasing baseline total bilirubin (P = 0.001), and increasing dose of amiodarone (P = 0.002) were found to be independent predictors for severe AILI. Among cases, linear regression analysis showed that baseline ALT was the only significant independent predictor of post-amiodarone ALT (P < 0.0001), while baseline AST (P < 0.0001) and EF (P = 0.012) were the only significant independent predictors of post-amiodarone AST.ConclusionsCompromised cardiac, hepatic, and hemodynamic conditions, with increasing dose of IV amiodarone were associated with AILI. Severity of liver injury had linear relationship with baseline aminotransferase levels and left ventricular systolic function.

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“…It is a selfsufficient biomarker of mortality jeopardy hence proven according to some studies. An elevated level of total bilirubin is a sign of ailment, however, in the present time it ensures the association of a low level augmented in the menace of the disease [37].…”

Section: Bilirubinmentioning

confidence: 69%

Applications of Different Biomarkers in the Diagnosis of Drug-induced Liver Injury

Sharma¹,

Yadav²,

Sharma³

2019

TOBIOMJ

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Biomarkers perform a significant function in the process of drug development. Biomarkers have been utilized in the safety assessment of drugs in clinical practice and also for personalization of medicines. To recognize the relation among considerable biological processes as well as clinical outcomes, it is important to increase our potential of treatments for all ailments, in addition to our understanding of normal and healthy physiology. Since the 1980s, using biomarkers is essential for substitutional results in long term assessments of main maladies, for example, cancer, as well as illness related to the heart. Now a days, biomarkers are highly important for unifying discovery of the drug and day by day improvements. The importance of biomarkers is increasing gradually with the advancement of novel therapeutics for the treatment and prevention of a broad range of diseases in order to overcome hepatotoxicity. These biomarkers are extensively used for the identification of disease and the field of medical research. The use of biomarkers in clinical as well as basic research has been promoted rapidly by the different drug regulation authorities for better outcomes in the future.

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Bilirubin alone as a biomarker for short-term mortality in acute-on-chronic liver failure: an important prognostic indicator

Cited by 73 publications

References 28 publications

The Relationship between Serum Bilirubin and Elevated Fibrotic Indices among HBV Carriers: A Cross-Sectional Study of a Chinese Population

The Relationship between Serum Bilirubin and Elevated Fibrotic Indices among HBV Carriers: A Cross-Sectional Study of a Chinese Population

Predictors of intravenous amiodarone induced liver injury

Applications of Different Biomarkers in the Diagnosis of Drug-induced Liver Injury

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