Key result
Higher admission total bilirubin predicts ~59% greater no-reflow risk and increased in-hospital major cardiovascular events in STEMI.
Why the study?
Does serum total bilirubin level on admission predict no-reflow and in-hospital MACE in patients with STEMI undergoing primary PCI?
Observational (n=536)
Does serum total bilirubin level on admission predict no-reflow and in-hospital MACE in patients with STEMI undergoing primary PCI?
Serum total bilirubin levels on admission can serve as an independent predictor for no-reflow and in-hospital MACE in STEMI patients undergoing primary PCI.
Answers are grounded in this paper and cite their sources.
May support admission bilirubin for risk stratification in STEMI; leaves open incremental value and need for prospective validation.
We evaluated the association of total bilirubin with post-percutaneous coronary intervention (PCI) coronary blood flow and in-hospital major adverse cardiac events (MACEs) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI. A total of 536 consecutive patients with STEMI (male 79%, mean age = 59.9 ± 12.6 years) admitted within 6 hours from symptom onset were enrolled. Patients were divided into 2 groups based on the thrombolysis in myocardial infarction (MI) flow grade. In-stent thrombosis, nonfatal MI, and in-hospital mortality were significantly higher in no-reflow group (P = .007, P = .002, and P < .001, respectively). On multivariate regression, the total bilirubin levels remained independent predictors of no-reflow (odds ratio [OR] 1.586, 95% confidence interval [CI] 1.02-2.47; P = .042) and in-hospital MACE (OR 1.399, 95% CI 1.053-1.857; P = .020). Serum bilirubin levels were independently associated with no-reflow and in-hospital MACE in patients with STEMI undergoing primary PCI.
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Celık et al. (2013) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=536). Total bilirubin levels was evaluated on no-reflow (OR 1.586, 95% CI 1.02-2.47, p=0.042). Total bilirubin levels on admission independently predicted no-reflow and in-hospital major cardiovascular events in STEMI patients.
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