title: Prognostic value of total bilirubin in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention.
abstract: Previous studies have shown that the serum total bilirubin (TB) concentration was inversely related with stable coronary artery disease, diabetes mellitus, hypertension, and metabolic syndromes. The relation between TB levels and in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI) is not known. Data from 1,624 consecutive patients with STEMI who underwent primary PCI were evaluated. TB was measured after primary PCI, and the study population was divided into tertiles. The high TB group (n = 450) was defined as a value in the upper third tertile (>0.9 mg/dl) and the low TB group (n = 1,174) as any value in the lower 2 tertiles (≤0.9 mg/dl). The in-hospital mortality rate was significantly greater in the high TB group than in the low TB group (4% vs 1.5%, p = 0.003). In the multivariate analyses, a significant association was noted between high TB levels and the adjusted risk of in-hospital cardiovascular mortality (odds ratio 3.24, 95% confidence interval 1.27 to 8.27, p = 0.014). In the receiver operating characteristic curve analysis, TB >0.90 mg/dl was identified as an effective cutpoint in patients with STEMI for in-hospital cardiovascular mortality (area under the curve 0.66, 95% confidence interval 0.55 to 0.76, p = 0.001). The mean follow-up period was 26.2 months. No differences were seen in the long-term mortality rates between the 2 groups. In conclusion, high TB is independently associated with in-hospital adverse outcomes in patients with STEMI who undergo primary PCI. However, no association was found with long-term mortality.
authors.affiliation: Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. drmg23@gmail.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gul
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ergelen
authors.forename: Ozgur
authors.initials: O
authors.lastname: Akgul
authors.forename: Gurkan
authors.initials: G
authors.lastname: Karaca
authors.forename: Selahattin
authors.initials: S
authors.lastname: Turen
authors.forename: Murat
authors.initials: M
authors.lastname: Ugur
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ertürk
authors.forename: Seref
authors.initials: S
authors.lastname: Kul
authors.forename: Ozgur
authors.initials: O
authors.lastname: Surgit
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bozbay
authors.forename: Nevzat
authors.initials: N
authors.lastname: Uslu
mesh_terms: D001663:Bilirubin / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D014421:Turkey / Q000453:epidemiology
chemical_list: D001663:Bilirubin