Bilirubin Levels and the Burden of Coronary Atherosclerosis in Patients With STEMI

Şahin, Ömer; Akpek, Mahmut; Elçik, Deniz; Karadavut, Serhat; Şimşek, Vedat; Tulmaç, Murat; Örsçelik, Özcan; Çalapkorur, Bekir; Ergin, Ali; Kaya, Mehmet

doi:10.1177/0003319712440619

Cited by 41 publications

(39 citation statements)

References 29 publications

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“…The heme oxygenase (HO) enzyme that is responsible for the degradation of heme groups in the metabolism of bilirubin is a stress-inducible enzyme and has antioxidative features [4]. There are 2 isozymes of this enzyme, HO-1 and HO-2 [5].…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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“…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. 11 HO-1 protein and HO activity are markedly upregulated in the myocardium in response to infarction and pressure overload in animals.…”

Section: Discussionmentioning

confidence: 93%

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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“…It has been suggested that the prognostic significance of TB is different in stable CAD and acute myocardial infarction (AMI) (Huang et al, 2017). For stable CAD, elevated TB levels are associated with better prognosis through reduction of cardiac reperfusion injury and improvement of postischemic cardiac function (Bakrania et al, 2017;Clark et al, 2000), while in AMI patients, elevated TB levels correlated with high burden thrombus (Hamur et al, 2016), coronary atherosclerosis (Sahin et al, 2013), and angiographic no-flow (Celik et al, 2014). The activity of myocardial heme oxygenase-1 (HO-1) increased significantly in response to acute infarction, and therefore, elevated TB levels represent stress-induced HO-1 activation in AMI patients (Okuhara et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Relation of total bilirubin and QT interval prolongation (from the Third National Health and Nutrition Examination Survey)

Majeed

Ahmad

Ahsan

et al. 2019

Noninvasive Electrocardiol

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Objective The association of bilirubin with cardiovascular disease (CVD) is controversial. We sought to explore the association of total bilirubin (TB) levels with QT interval in a multiracial cohort. Methods A total of 6,627 participants (59.0 ± 13.3 years; 52.6% women, 49.7% Non‐Hispanic Whites) without CVD from the Third National Health and Nutrition Examination Survey were included in this analysis. QT was automatically measured from digital 12‐lead electrocardiogram in a central reading center. A multivariable logistic regression model was used to examine the cross‐sectional association between tertiles of TB and prolonged QT interval (≥450 ms in men and ≥460 ms in women). Results The prevalence of prolonged QT was higher among those with higher levels of TB (prolonged QT prevalence was 4.7%, 6.8%, and 7.0% across TB lower (0–0.4 mg/dl), middle (0.5–1.6 mg/dl), and higher (0.70–4.30 mg/dl) tertiles, respectively). In a model adjusted for potential confounders, participants within the highest TB tertile had significantly greater odds of the prolonged QT interval (Odds ratios [95% confidence interval] 1.53 [1.16–2.02]) compared to those with bilirubin levels in the first tertile. Each 0.29 mg/dl increase in TB levels was associated with a 12% (p‐value <.0001) increase in the prevalence of prolonged QT interval. This association was stronger in men than in women (interaction p‐value = .04). Conclusion Elevated bilirubin levels are associated with a prolonged QT interval. This finding extends our current knowledge on the relationship between serum bilirubin and CVD by demonstrating a link between higher TB and abnormal cardiac repolarization.

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Bilirubin Levels and the Burden of Coronary Atherosclerosis in Patients With STEMI

Cited by 41 publications

References 29 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

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

Relation of total bilirubin and QT interval prolongation (from the Third National Health and Nutrition Examination Survey)

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