title: Bilirubin in coronary artery disease: Cytotoxic or protective?
abstract: Bilirubin has traditionally been considered a cytotoxic waste product. However, recent studies have shown bilirubin to have anti-oxidant, anti-inflammatory, vasodilatory, anti-apoptotic and anti-proliferative functions. These properties potentially confer bilirubin a new role of protection especially in coronary artery disease (CAD), which is a low grade inflammatory process exacerbated by oxidative stress. In fact, recent literature reports an inverse relationship between serum concentration of bilirubin and the presence of CAD. In this article, we review the current literature exploring the association between levels of bilirubin and risk of CAD. We conclude that current evidence is inconclusive regarding the protective effect of bilirubin on CAD. A causal relationship between low serum bilirubin level and increased risk of CAD is not currently established.
authors.affiliation: Nancy Gupta, Sachin Sule, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
authors.forename: Nancy
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Nancy Gupta, Sachin Sule, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
authors.forename: Tavankit
authors.initials: T
authors.lastname: Singh
authors.affiliation: Nancy Gupta, Sachin Sule, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
authors.forename: Rahul
authors.initials: R
authors.lastname: Chaudhary
authors.affiliation: Nancy Gupta, Sachin Sule, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
authors.forename: Sushil K
authors.initials: SK
authors.lastname: Garg
authors.affiliation: Nancy Gupta, Sachin Sule, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
authors.forename: Gurprataap Singh
authors.initials: GS
authors.lastname: Sandhu
authors.affiliation: Nancy Gupta, Sachin Sule, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
authors.forename: Varun
authors.initials: V
authors.lastname: Mittal
authors.affiliation: Nancy Gupta, Sachin Sule, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
authors.forename: Rahul
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Nancy Gupta, Sachin Sule, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
authors.forename: Roxana
authors.initials: R
authors.lastname: Bodin
authors.affiliation: Nancy Gupta, Sachin Sule, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY 10595, United States.
authors.forename: Sachin
authors.initials: S
authors.lastname: Sule
keywords: Anti coronary artery disease; Anti-inflammatory; Anti-oxidant; Bilirubin; Cytotoxic; Gilbert; Lipid peroxidation; Protective