Association of serum bilirubin with SYNTAX Score and future cardiovascular events in patients undergoing coronary intervention

Chun Chin Chang, Chien Yi Hsu, Po Hsun Huang, Chia Hung Chiang, Shao Sung Huang, Hsin Bang Leu, Chin Chou Huang, Jaw Wen Chen, Shing Jong Lin

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Abstract

Background: Bilirubin has emerged as an important endogenous antioxidant molecule, and increasing evidence shows that bilirubin may protect against atherosclerosis. The SYNTAX score has been developed to assess the severity and complexity of coronary artery disease. The aim of this study was to evaluate whether serum bilirubin levels are associated with SYNTAX scores andwhether they could be used to predict future cardiovascular events in patients undergoing coronary intervention. Methods: Serum bilirubin levels and other blood parameters in patients with at least 12-h fasting states were determined. The primary endpoint was any composite cardiovascular event within 1 year, including death, nonfatal myocardial infarction, and target-vessel revascularization. Results: In total, 250 consecutive patients with stable coronary artery disease (mean age 70 ± 13) who had received coronary intervention were enrolled. All study subjects were divided into two groups: group 1 was defined as high SYNTAX score (> 22), and group 2 was defined as low SYNTAX score (≤ 22). Total bilirubin levels were significantly lower in the high SYNTAX score group than in the low SYNTAX score group (0.51 ± 0.22 vs. 0.72 ± 0.29 mg/dl, p < 0.001). By multivariate analysis, serum total bilirubin levels were identified as an independent predictor for high SYNTAX score (adjusted odds ratio: 0.28, 95% confidence interval 0.04-0.42; p = 0.004). Use of the Kaplan-Meier analysis demonstrated a significant difference in 1-year cardiovascular events between high (> 0.8mg/dl), medium (> 0.5, ≤ 0.8 mg/dl), and low (≤ 0.5 mg/dl) bilirubin levels (log-rank test p = 0.011). Conclusions: Serum bilirubin level is associated with SYNTAX score and predicts future cardiovascular events in patients undergoing coronary intervention.

Original languageEnglish
Pages (from-to)412-419
Number of pages8
JournalActa Cardiologica Sinica
Volume32
Issue number4
DOIs
Publication statusPublished - Jul 1 2016
Externally publishedYes

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Keywords

  • Cardiovascular events
  • Serum bilirubin
  • SYNTAX score

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Chang, C. C., Hsu, C. Y., Huang, P. H., Chiang, C. H., Huang, S. S., Leu, H. B., Huang, C. C., Chen, J. W., & Lin, S. J. (2016). Association of serum bilirubin with SYNTAX Score and future cardiovascular events in patients undergoing coronary intervention. Acta Cardiologica Sinica, 32(4), 412-419. https://doi.org/10.6515/ACS20150708C