[Effect of elevated bilirubin levels on the long-term outcome in patients with chronic heart failure due to hypertension].
OBJECTIVE
The aim of the study was to evaluate the occurence of death and major adverse cardiac events (MACE) in patients with normal (group A) and elevated (group B) plasma bilirubin levels.


METHODS
We evaluated 124 patients (83% males, mean age 50.1 +/- 7.7 yrs) in New York Heart Association class II and III with hypertension-related chronic heart failure. We assessed the occurence of death and MACE (death, urgent heart transplantation and readmission to hospital).


RESULTS
Groups A and B comprised 77 and 47 patients respectively. The independent predictors of death in group B were: N-terminal pro-brain natriuretic peptide (NT-proBNP) level (per 100 pg/ml difference; 95% CI: 1.29-4.76; p = 0.005) and physical component summary score (per 10 point difference; 95% CI: 0.66-0.99; p = 0.03). The independent predictors of MACE in group B were: age (per 10 yrs; 95% CI: 0.1-1.8; p = 0.04), NT-proBNP level (per 100 pg/ml difference; 95% CI: 1.02-3.69; p = 0.04) and the symptoms of depression (95% CI: 1.02-2.5; p = 0.01). The independent predictors of MACE in group A were: NT-proBNP level (per 100 pg/ml difference; 95% CI: 1.31-5.32; p = 0.006) and mental component summary (per 10 point difference; 95% CI: 0.85-0.98; p = 0.01). In a two-year follow-up the death rate was 5.2% in group A, and 23.4% in group B (p = 0.002) and frequency of MACE 18.2% and 42.6% in group A and B (p = 0.003), respectively.


CONCLUSIONS
Elevated bilirubin levels are associated with higher incidence of death and MACE during a two-year follow-up in patients with hypertension-related chronic heart failure. Thus, it may be used as a simple prognostic factor in such of patients.
Szyguła-Jurkiewicz
Bozena
B
III Katedra i Oddział Kliniczny Kardiologii, Slaski Uniwersytet Medyczny, Katowice. b.szygula@sccs.pl
Wojnicz
Romuald
R
Lekston
Andrzej
A
Duszańska
Agata
A
Spinczyk
Beata
B
Nowak
Jolanta
J
Niklewski
Tomasz
T
Halewski
Krzysztof
K
Poloński
Lech
L
D000328:Adult; D000367:Age Factors; D001663:Bilirubin / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D001663:Bilirubin