title: Association of Serum Bilirubin with SYNTAX Score and Future Cardiovascular Events in Patients Undergoing Coronary Intervention.
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 and whether 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 (> 0.8 mg/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.
authors.affiliation: Division of Cardiology, Department of Medicine; ; Cardiovascular Research Center;
authors.forename: Chun-Chin
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Cardiovascular Research Center; ; Institute of Clinical Medicine, National Yang-Ming University, Taipei; ; Department of Medicine, Taipei Veterans General Hospital Yuli Branch, Hualien, Taiwan.
authors.forename: Chien-Yi
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Division of Cardiology, Department of Medicine; ; Cardiovascular Research Center; ; Institute of Clinical Medicine, National Yang-Ming University, Taipei;
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Huang
authors.affiliation: Cardiovascular Research Center; ; Institute of Clinical Medicine, National Yang-Ming University, Taipei;
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Chiang
authors.affiliation: Division of Cardiology, Department of Medicine; ; Healthcare and Management Center, Taipei Veterans General Hospital; ; Cardiovascular Research Center; ; Institute of Clinical Medicine, National Yang-Ming University, Taipei;
authors.forename: Shao-Sung
authors.initials: SS
authors.lastname: Huang
authors.affiliation: Division of Cardiology, Department of Medicine; ; Healthcare and Management Center, Taipei Veterans General Hospital; ; Cardiovascular Research Center; ; Institute of Clinical Medicine, National Yang-Ming University, Taipei;
authors.forename: Hsin-Bang
authors.initials: HB
authors.lastname: Leu
authors.affiliation: Division of Cardiology, Department of Medicine; ; Department of Medical Education; ; Cardiovascular Research Center; ; Institute of Pharmacology;
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Cardiology, Department of Medicine; ; Division of Clinical Research; ; Cardiovascular Research Center; ; Institute of Pharmacology;
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Department of Medicine; ; Department of Medical Research; ; Cardiovascular Research Center; ; Institute of Clinical Medicine, National Yang-Ming University, Taipei;
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
keywords: Cardiovascular events; SYNTAX score; Serum bilirubin